- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $11.22 / $33.11
| Facility | | $4.90 | $11.22 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.62 / $17.78
| Professional | | $3.02 | $5.62 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $15.14
| Facility | | $5.75 | $5.75 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $3.47 / $11.22
| Professional | | $2.34 | $3.47 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $5.75 / $5.75
| Facility | | $3.47 | $5.75 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.75 / $5.75
| Professional | | $4.27 | $5.75 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $12.59 / $45.71
| Facility | | $5.62 | $12.59 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $7.94 / $30.20
| Professional | | $3.39 | $7.94 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $6.17 / $15.85
| Facility | | $3.02 | $6.17 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $4.17 / $10.96
| Professional | | $2.75 | $4.17 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $3.47
| Facility | | $3.47 | $3.47 | $3.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.37 / $6.92
| Professional | | $3.47 | $4.37 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.46 / $72.44
| Facility | | $5.13 | $6.46 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $10.47 / $50,118.72
| Facility | | $5.25 | $10.47 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $6.17 / $7.94
| Facility | | $3.80 | $6.17 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $4.17 / $12.30
| Professional | | $2.88 | $4.17 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.07 / $10.00
| Facility | | $3.47 | $4.07 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $5.01 / $12.30
| Professional | | $3.47 | $5.01 | $12.30 |