- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $17.78 / $28.18
| Facility | | $8.32 | $17.78 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $10.96
| Professional | | $3.98 | $5.01 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $45.71 / $5,011.87
| Facility | | $33.88 | $45.71 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $6.17
| Professional | | $5.01 | $5.01 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $9.12 / $22.39
| Facility | | $4.68 | $9.12 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $3.47
| Professional | | $3.47 | $3.47 | $3.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.80 / $9.33
| Professional | | $3.02 | $3.80 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $6.46
| Facility | | $6.46 | $6.46 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $6.76 / $11.22
| Professional | | $5.50 | $6.76 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $16.98 / $22.91
| Facility | | $5.01 | $16.98 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $7.08
| Professional | | $3.98 | $5.01 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $6.46 / $9.55
| Facility | | $3.16 | $6.46 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $5.75 / $9.55
| Professional | | $3.16 | $5.75 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $6.46 / $7.76
| Facility | | $3.80 | $6.46 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.27 / $11.22
| Professional | | $2.69 | $4.27 | $11.22 |