- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $7.41 / $12.02
| Facility | | $2.69 | $7.41 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $6.03
| Professional | | $3.02 | $3.98 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $6.03
| Facility | | $4.27 | $4.27 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.27 / $5,011.87
| Facility | | $3.63 | $4.27 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.07 / $4.07
| Professional | | $4.07 | $4.07 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $11.75 / $12.59
| Facility | | $3.31 | $11.75 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $3.31
| Professional | | $3.31 | $3.31 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $3.31
| Facility | | $3.31 | $3.31 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.75 / $5.75
| Professional | | $5.01 | $5.75 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $13.18
| Facility | | $4.27 | $4.27 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $6.03
| Facility | | $4.27 | $4.27 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $3.89 / $10.00
| Facility | | $2.88 | $3.89 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.63 / $5.25
| Professional | | $3.02 | $3.63 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.47 / $4.27
| Facility | | $3.24 | $3.47 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.47 / $4.27
| Professional | | $2.75 | $3.47 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.37 / $5.62
| Professional | | $3.98 | $4.37 | $5.62 |