- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $40.74 / $186.21
| Facility | | $14.45 | $40.74 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.51 / $26.92
| Professional | | $7.08 | $8.51 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.75 / $9.55
| Professional | | $5.62 | $5.75 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $42.66 / $758.58
| Facility | | $14.79 | $42.66 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $66.07 / $5,011.87
| Facility | | $50.12 | $66.07 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $8.91
| Professional | | $7.41 | $7.41 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $14.45 / $32.36
| Facility | | $6.76 | $14.45 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $12.02 / $23.44
| Professional | | $5.50 | $12.02 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $9.55 / $13.80
| Professional | | $4.47 | $9.55 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $9.55 / $9.55
| Facility | | $9.55 | $9.55 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $10.47 / $16.60
| Professional | | $9.55 | $10.47 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $23.99 / $54.95
| Facility | | $12.88 | $23.99 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $6.31 / $8.13
| Professional | | $5.62 | $6.31 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $39.81 / $954.99
| Facility | | $10.96 | $39.81 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $14.79 / $41.69
| Facility | | $6.61 | $14.79 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.94 / $15.49
| Professional | | $7.08 | $7.94 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $660.69 / $5,495.41
| Facility | | $630.96 | $660.69 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $10.47 / $10.47
| Facility | | $1.12 | $10.47 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $10.47 / $13.49
| Professional | | $1.12 | $10.47 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $9.55 / $11.48
| Facility | | $5.50 | $9.55 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $7.08 / $16.60
| Professional | | $4.27 | $7.08 | $16.60 |