- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $7.94 / $6,025.60
| Facility | | $5.62 | $7.94 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.62 / $3,235.94
| Professional | | $5.01 | $5.62 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $5.75
| Facility | | $5.50 | $5.50 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $5.50
| Professional | | $5.50 | $5.50 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $6.03
| Facility | | $5.75 | $5.75 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $5.75
| Professional | | $5.75 | $5.75 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $7.24 / $8.32
| Facility | | $5.89 | $7.24 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $23.99
| Professional | | $5.50 | $5.50 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $6.76 / $19.05
| Facility | | $5.25 | $6.76 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $8.32
| Professional | | $5.75 | $5.75 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $6.03
| Facility | | $5.75 | $5.75 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $5.75
| Professional | | $5.75 | $5.75 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $3.63 / $7.94
| Facility | | $3.63 | $3.63 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $14.45 / $53,703.18
| Facility | | $6.31 | $14.45 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.89 / $9.77
| Facility | | $5.50 | $5.89 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.89 / $10.47
| Professional | | $5.62 | $5.89 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $6.61
| Facility | | $5.75 | $5.75 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $5.75 / $6.92
| Professional | | $3.72 | $5.75 | $6.92 |