- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $9.33 / $30.20
| Facility | | $3.80 | $9.33 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.72 / $7.94
| Professional | | $3.02 | $3.72 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $177.83 / $380.19
| Facility | | $4.07 | $177.83 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $3.98
| Professional | | $3.98 | $3.98 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.07 / $5,011.87
| Facility | | $3.47 | $4.07 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $3.89 / $3.89
| Professional | | $3.89 | $3.89 | $3.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $13.18 / $14.13
| Facility | | $3.72 | $13.18 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $3.72 / $3.72
| Professional | | $3.72 | $3.72 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $3.72 / $3.72
| Facility | | $3.72 | $3.72 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $6.46 / $6.46
| Professional | | $5.62 | $6.46 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $7.76 / $19.50
| Facility | | $1.41 | $7.76 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $177.83 / $380.19
| Facility | | $4.07 | $177.83 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $3.98
| Professional | | $3.98 | $3.98 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $5.62 / $9.55
| Facility | | $3.72 | $5.62 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $4.07
| Professional | | $3.02 | $3.02 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $3.31 / $5.25
| Facility | | $1.07 | $3.31 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $3.31 / $4.57
| Professional | | $1.07 | $3.31 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $3.72 / $5.13
| Professional | | $3.72 | $3.72 | $5.13 |