- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $16.98 / $933.25
| Facility | | $6.31 | $16.98 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $5.01 / $23.44
| Professional | | $3.16 | $5.01 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.76 / $11.75
| Facility | | $5.75 | $6.76 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.24 / $7.94
| Professional | | $2.51 | $3.24 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.07 / $7.24
| Facility | | $4.07 | $4.07 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.51 / $8.51
| Professional | | $8.51 | $8.51 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $8.13 / $25.70
| Facility | | $4.17 | $8.13 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $3.55 / $9.55
| Professional | | $2.45 | $3.55 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $8.32 / $107.15
| Facility | | $4.17 | $8.32 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $3.39 / $7.76
| Professional | | $2.34 | $3.39 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.75 / $7.76
| Professional | | $4.79 | $5.75 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $436.52 / $891.25
| Facility | | $331.13 | $436.52 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.61 / $12.88
| Professional | | $4.47 | $6.61 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $14.79 / $812.83
| Facility | | $3.16 | $14.79 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.24 / $6.31
| Professional | | $2.24 | $3.24 | $6.31 |