- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $794.33 / $2,238.72
| Facility | | $7.08 | $794.33 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.92 / $7.08
| Professional | | $6.03 | $6.92 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $13.80 / $23.44
| Facility | | $6.92 | $13.80 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $11.48
| Professional | | $6.92 | $6.92 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $10.47 / $15.85
| Professional | | $9.12 | $10.47 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $12.88 / $17.38
| Facility | | $9.55 | $12.88 | $17.38 |
- 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
- $5.89 / $6.92 / $8.32
| Professional | | $5.89 | $6.92 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $10.96
| Facility | | $6.92 | $6.92 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $7.59 / $10.23
| Facility | | $6.61 | $7.59 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $7.59 / $10.23
| Professional | | $6.61 | $7.59 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $6.92 / $13.80
| Facility | | $6.31 | $6.92 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $6.92 / $7.24
| Professional | | $6.31 | $6.92 | $7.24 |