- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $10.96 / $21.88
| Facility | | $5.75 | $10.96 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $8.71
| Professional | | $3.02 | $3.98 | $8.71 |
- 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 / $2.88 / $12.02
| Professional | | $2.34 | $2.88 | $12.02 |
- 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 / $51.29
| Facility | | $5.62 | $12.59 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $7.08 / $28.18
| Professional | | $3.47 | $7.08 | $28.18 |
- 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
- $2.69 / $4.07 / $11.22
| Professional | | $2.69 | $4.07 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $4.79 / $4.79
| Facility | | $4.79 | $4.79 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.62 / $7.08
| Professional | | $4.37 | $5.62 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.13 / $6.76
| Facility | | $3.98 | $5.13 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $10.47 / $50,118.72
| Facility | | $5.89 | $10.47 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $6.92 / $7.76
| Facility | | $3.80 | $6.92 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $4.17 / $12.88
| Professional | | $2.88 | $4.17 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $4.90 / $11.48
| Facility | | $4.79 | $4.90 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.75 / $15.49
| Professional | | $4.57 | $5.75 | $15.49 |