- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $7.76 / $91.20
| Facility | | $5.50 | $7.76 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $9.33
| Professional | | $5.01 | $5.01 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $5.01
| Professional | | $5.01 | $5.01 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $9.12
| Facility | | $8.71 | $8.71 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $8.71
| Professional | | $8.71 | $8.71 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $6.61 / $85.11
| Facility | | $5.50 | $6.61 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $7.08
| Professional | | $5.01 | $5.01 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.17 / $16.98
| Facility | | $4.68 | $6.17 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.37 / $7.41
| Professional | | $5.25 | $5.37 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $33.11
| Facility | | $7.76 | $7.76 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $33.11 / $33.11
| Professional | | $7.76 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $21.88 / $21.88
| Facility | | $21.88 | $21.88 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $50,118.72 / $75,857.76
| Facility | | $2.51 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $3.72 / $20.89
| Professional | | $3.72 | $3.72 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $35.48
| Facility | | $7.24 | $7.24 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $7.94 / $9.12
| Professional | | $2.14 | $7.94 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $33.11
| Facility | | $7.76 | $7.76 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $33.11 / $33.11
| Professional | | $7.76 | $33.11 | $33.11 |