- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $15.14 / $2,398.83
| Facility | | $12.30 | $15.14 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.92 / $16.98
| Professional | | $6.03 | $6.92 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $8.13 / $16.60
| Facility | | $7.24 | $8.13 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $19.50
| Professional | | $6.92 | $6.92 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $7.76 / $11.75
| Facility | | $6.61 | $7.76 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $8.71 / $18.20
| Professional | | $6.92 | $8.71 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $11.75 / $15.85
| Facility | | $7.08 | $11.75 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $6.92
| Professional | | $6.92 | $6.92 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $7.59 / $15.85
| Professional | | $6.17 | $7.59 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $85.11 / $85.11
| Facility | | $79.43 | $85.11 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $10.47 / $17.38
| Facility | | $6.92 | $10.47 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $7.41
| Professional | | $6.92 | $6.92 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $7.59 / $11.75
| Professional | | $5.50 | $7.59 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $6.92
| Facility | | $6.92 | $6.92 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $14.79
| Professional | | $6.92 | $6.92 | $14.79 |