- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $21.38 / $794.33
| Facility | | $5.62 | $21.38 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.02 / $28.18
| Professional | | $2.00 | $3.02 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $10.47 / $7,244.36
| Facility | | $3.80 | $10.47 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $17.78 / $5,011.87
| Facility | | $13.18 | $17.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $3.02
| Professional | | $3.02 | $3.02 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $6.03 / $13.49
| Facility | | $2.75 | $6.03 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $4.90 / $9.33
| Professional | | $2.29 | $4.90 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $3.80 / $5.50
| Professional | | $1.82 | $3.80 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $3.80
| Facility | | $3.80 | $3.80 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.72 / $6.61
| Professional | | $2.69 | $3.72 | $6.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $363.08 / $1,318.26
| Facility | | $20.89 | $363.08 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $2.82 / $2.88
| Professional | | $2.29 | $2.82 | $2.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $9.55 / $512.86
| Facility | | $3.80 | $9.55 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $7.08 / $234.42
| Facility | | $3.24 | $7.08 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.02 / $5.37
| Professional | | $2.00 | $3.02 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $616.60 / $2,041.74
| Facility | | $616.60 | $616.60 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $1.45 / $5.13
| Facility | | $1.45 | $1.45 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $3.80 / $7.76
| Professional | | $1.45 | $3.80 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $794.33 / $1,202.26
| Facility | | $2.24 | $794.33 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $2.51 / $6.03
| Professional | | $1.62 | $2.51 | $6.03 |