- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $11.48 / $16.22
| Facility | | $5.01 | $11.48 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $10.00 / $12.88
| Professional | | $6.03 | $10.00 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $28.84
| Facility | | $14.45 | $14.45 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.25 / $20.42
| Professional | | $3.98 | $5.25 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.51 / $12.02
| Facility | | $8.51 | $8.51 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.51 / $8.51
| Professional | | $8.51 | $8.51 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $50,118.72 / $53,703.18
| Facility | | $22.91 | $50,118.72 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $5.89 / $69.18
| Professional | | $5.89 | $5.89 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $23.99 / $56.23
| Facility | | $14.45 | $23.99 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $26.30 / $40.74
| Professional | | $14.45 | $26.30 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.32 / $11.22
| Facility | | $8.13 | $8.32 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.71 / $11.22
| Professional | | $8.13 | $8.71 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $50,118.72 / $75,857.76
| Facility | | $23.99 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $54.95
| Facility | | $14.45 | $14.45 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $14.13 / $32.36
| Professional | | $6.31 | $14.13 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.32 / $8.32
| Facility | | $8.13 | $8.32 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.71 / $11.22
| Professional | | $8.13 | $8.71 | $11.22 |