- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $27.54 / $43.65
| Facility | | $12.30 | $27.54 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $21.38
| Professional | | $7.94 | $10.96 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $38.02
| Facility | | $14.45 | $14.45 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $6.46 / $27.54
| Professional | | $5.89 | $6.46 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $14.45 / $14.45
| Facility | | $8.71 | $14.45 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $14.45 / $14.45
| Professional | | $10.72 | $14.45 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $31.62 / $117.49
| Facility | | $14.13 | $31.62 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $17.78 / $72.44
| Professional | | $8.71 | $17.78 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $16.98 / $39.81
| Facility | | $8.51 | $16.98 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $10.23 / $28.18
| Professional | | $6.92 | $10.23 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $14.45
| Facility | | $14.45 | $14.45 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $14.45 / $17.38
| Professional | | $4.90 | $14.45 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $9.77
| Facility | | $9.77 | $9.77 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $27.54 / $50,118.72
| Facility | | $6.46 | $27.54 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $15.85 / $19.50
| Facility | | $9.55 | $15.85 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $9.55 / $33.11
| Professional | | $6.17 | $9.55 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $14.45 / $17.38
| Facility | | $12.30 | $14.45 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $14.45 / $19.05
| Professional | | $5.50 | $14.45 | $19.05 |