- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $33.88 / $97.72
| Facility | | $8.13 | $33.88 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $22.91
| Professional | | $6.03 | $7.08 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.79 / $8.13
| Professional | | $4.07 | $4.79 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $37.15 / $389.05
| Facility | | $12.88 | $37.15 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $5.75
| Professional | | $5.25 | $5.25 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $56.23 / $5,011.87
| Facility | | $42.66 | $56.23 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $6.31 / $7.76
| Professional | | $6.31 | $6.31 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $12.30 / $28.18
| Facility | | $5.75 | $12.30 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $10.23 / $19.50
| Professional | | $4.79 | $10.23 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $8.13 / $11.75
| Professional | | $3.80 | $8.13 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $8.13
| Facility | | $8.13 | $8.13 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.91 / $14.13
| Professional | | $8.13 | $8.91 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $22.91 / $67.61
| Facility | | $12.59 | $22.91 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $4.79 / $6.61
| Professional | | $4.79 | $4.79 | $6.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $36.31 / $81.28
| Facility | | $9.33 | $36.31 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $5.25
| Professional | | $5.25 | $5.25 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $17.38 / $46.77
| Facility | | $6.61 | $17.38 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $14.13
| Professional | | $6.03 | $7.08 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $17.38 / $23.99
| Facility | | $16.98 | $17.38 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.91 / $9.55
| Facility | | $8.13 | $8.91 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $9.55
| Professional | | $7.08 | $8.91 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $8.13 / $9.77
| Facility | | $4.47 | $8.13 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $6.03 / $14.13
| Professional | | $3.63 | $6.03 | $14.13 |