- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $64.57 / $181.97
| Facility | | $5.01 | $64.57 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.69 / $10.96
| Professional | | $2.00 | $2.69 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $4.27 / $125.89
| Facility | | $2.75 | $4.27 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $3.02 / $7.24
| Professional | | $1.78 | $3.02 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $151.36 / $218.78
| Facility | | $123.03 | $151.36 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $2.82 / $3.80
| Professional | | $2.82 | $2.82 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $4.68 / $11.48
| Facility | | $2.34 | $4.68 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $3.31 / $8.13
| Professional | | $1.78 | $3.31 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $26.92 / $7,079.46
| Facility | | $3.39 | $26.92 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.17 / $4.90
| Professional | | $4.17 | $4.17 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $9.77
| Professional | | $3.02 | $3.02 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $6.92 / $173.78
| Facility | | $3.72 | $6.92 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $4.27 / $125.89
| Facility | | $2.75 | $4.27 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $3.02 / $7.24
| Professional | | $1.78 | $3.02 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $5.75 / $263.03
| Facility | | $2.63 | $5.75 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.02 / $4.47
| Professional | | $2.63 | $3.02 | $4.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $3.63 / $354.81
| Facility | | $1.51 | $3.63 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $3.02 / $11.22
| Professional | | $1.78 | $3.02 | $11.22 |