- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $39.81 / $107.15
| Facility | | $10.47 | $39.81 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $16.98 / $60.26
| Professional | | $6.92 | $16.98 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $11.22
| Professional | | $11.22 | $11.22 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $10.47
| Facility | | $7.59 | $7.59 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $7.24
| Professional | | $7.24 | $7.24 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $7.41 / $5,011.87
| Facility | | $6.31 | $7.41 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $24.55 / $26.30
| Facility | | $6.92 | $24.55 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $6.92
| Professional | | $6.92 | $6.92 | $6.92 |
- 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
- $10.47 / $12.02 / $12.02
| Professional | | $10.47 | $12.02 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $28.84 / $44.67
| Facility | | $9.12 | $28.84 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $10.47
| Facility | | $7.59 | $7.59 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $7.24
| Professional | | $7.24 | $7.24 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $10.47 / $20.89
| Facility | | $6.92 | $10.47 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $12.59
| Professional | | $6.03 | $7.08 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.13 / $8.13
| Facility | | $6.03 | $8.13 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.13 / $23.99
| Professional | | $6.03 | $8.13 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $11.48
| Professional | | $6.92 | $6.92 | $11.48 |