- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $12.88 / $37.15
| Facility | | $4.57 | $12.88 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.80 / $13.80
| Professional | | $3.02 | $3.80 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $2.63 / $2.63
| Professional | | $2.63 | $2.63 | $2.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $19.05 / $269.15
| Facility | | $6.03 | $19.05 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $30.20 / $5,011.87
| Facility | | $22.39 | $30.20 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $4.07
| Professional | | $3.31 | $3.31 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $6.46 / $14.45
| Facility | | $3.09 | $6.46 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $5.50 / $10.00
| Professional | | $2.45 | $5.50 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.47 / $6.17
| Professional | | $2.00 | $3.47 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $4.27
| Facility | | $4.27 | $4.27 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.79 / $7.41
| Professional | | $4.27 | $4.79 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $10.47 / $22.39
| Facility | | $5.75 | $10.47 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $2.88 / $3.31
| Professional | | $2.57 | $2.88 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $16.22 / $38.02
| Facility | | $6.61 | $16.22 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $6.46 / $14.45
| Facility | | $3.02 | $6.46 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.02 / $6.31
| Professional | | $2.24 | $3.02 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $5.01 / $5.37
| Facility | | $2.51 | $5.01 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $5.13 / $8.32
| Professional | | $2.51 | $5.13 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $4.27 / $5.13
| Facility | | $2.51 | $4.27 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $4.27 / $7.24
| Professional | | $2.57 | $4.27 | $7.24 |