- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $7.94 / $11.22
| Facility | | $3.98 | $7.94 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.03 / $9.33
| Professional | | $3.98 | $6.03 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $8.32 / $14.13
| Professional | | $5.25 | $8.32 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $8.32 / $8.32
| Facility | | $7.59 | $8.32 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $8.32
| Professional | | $8.32 | $8.32 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $6.31 / $53,703.18
| Facility | | $5.89 | $6.31 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $11.75
| Professional | | $5.01 | $5.01 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $16.60 / $38.90
| Facility | | $10.00 | $16.60 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $10.00 / $19.05
| Professional | | $6.46 | $10.00 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $6.76
| Facility | | $6.46 | $6.46 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.08 / $7.08
| Professional | | $6.46 | $7.08 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $50,118.72 / $75,857.76
| Facility | | $13.80 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $9.55 / $9.55
| Professional | | $6.61 | $9.55 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.17 / $10.00
| Facility | | $3.47 | $4.17 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $6.61 / $16.60
| Professional | | $3.47 | $6.61 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.08 / $7.08
| Facility | | $6.46 | $7.08 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.08 / $7.08
| Professional | | $6.46 | $7.08 | $7.08 |