- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $11.22 / $18.20
| Facility | | $8.13 | $11.22 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $12.30
| Professional | | $5.01 | $5.01 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $6.46 / $15.49
| Facility | | $5.62 | $6.46 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.37 / $13.49
| Professional | | $5.13 | $5.37 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $7.08 / $10.47
| Facility | | $6.17 | $7.08 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $6.92 / $15.14
| Professional | | $5.37 | $6.92 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $8.91 / $11.75
| Facility | | $5.37 | $8.91 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $5.37
| Professional | | $5.13 | $5.13 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $5.89 / $12.02
| Professional | | $4.68 | $5.89 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $6,918.31 / $6,918.31
| Facility | | $6,918.31 | $6,918.31 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $5.13
| Professional | | $5.13 | $5.13 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $7.76 / $12.30
| Facility | | $5.13 | $7.76 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $9.12
| Professional | | $5.13 | $5.13 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $7.76
| Professional | | $7.76 | $7.76 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.62 / $8.71
| Professional | | $4.07 | $5.62 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $15.14 / $15.14
| Facility | | $5.13 | $15.14 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $13.80
| Professional | | $5.37 | $5.37 | $13.80 |