- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $38.90 / $141.25
| Facility | | $12.88 | $38.90 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.76 / $19.50
| Professional | | $6.03 | $7.76 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.25 / $8.71
| Professional | | $4.27 | $5.25 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $38.90 / $794.33
| Facility | | $13.49 | $38.90 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $6.17
| Professional | | $5.62 | $5.62 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $60.26 / $5,011.87
| Facility | | $45.71 | $60.26 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $8.32
| Professional | | $6.76 | $6.76 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $13.18 / $28.84
| Facility | | $6.17 | $13.18 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $10.96 / $20.89
| Professional | | $5.13 | $10.96 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.32 / $12.59
| Professional | | $4.07 | $8.32 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $16.60
| Facility | | $8.71 | $8.71 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $9.55 / $14.79
| Professional | | $8.71 | $9.55 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $23.44 / $56.23
| Facility | | $12.30 | $23.44 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.75 / $8.51
| Professional | | $5.13 | $5.75 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $37.15 / $794.33
| Facility | | $10.00 | $37.15 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $5.62
| Professional | | $5.62 | $5.62 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $15.85 / $74.13
| Facility | | $6.03 | $15.85 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.59 / $15.14
| Professional | | $6.03 | $7.59 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $776.25 / $3,890.45
| Facility | | $741.31 | $776.25 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $7.08 / $16.60
| Facility | | $4.90 | $7.08 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $8.71 / $16.60
| Professional | | $4.90 | $8.71 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $8.71 / $10.23
| Facility | | $4.79 | $8.71 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.75 / $15.14
| Professional | | $3.89 | $5.75 | $15.14 |