- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $18.20 / $87.10
| Facility | | $8.13 | $18.20 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $9.77
| Professional | | $6.03 | $7.08 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $20.89
| Facility | | $8.13 | $8.13 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.79 / $18.62
| Professional | | $3.98 | $4.79 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $8.13 / $8.13
| Facility | | $4.79 | $8.13 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $8.13 / $8.13
| Professional | | $5.89 | $8.13 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $17.78 / $87.10
| Facility | | $7.94 | $17.78 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $11.75 / $53.70
| Professional | | $5.50 | $11.75 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $9.55 / $22.39
| Facility | | $5.50 | $9.55 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $5.62 / $15.85
| Professional | | $3.80 | $5.62 | $15.85 |
- 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
- $7.08 / $8.13 / $12.02
| Professional | | $7.08 | $8.13 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $8.91 / $23.44
| Facility | | $5.62 | $8.91 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.14 / $50,118.72
| Facility | | $10.00 | $15.14 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $9.77 / $13.18
| Facility | | $6.17 | $9.77 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $6.03 / $18.62
| Professional | | $3.39 | $6.03 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $8.13 / $19.50
| Facility | | $6.92 | $8.13 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $8.51 / $26.30
| Professional | | $6.92 | $8.51 | $26.30 |