- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $13.49 / $21.88
| Facility | | $6.03 | $13.49 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $8.91
| Professional | | $3.02 | $3.98 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $35.48 / $5,011.87
| Facility | | $26.92 | $35.48 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $3.89 / $5.01
| Professional | | $3.89 | $3.89 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $6.92 / $16.60
| Facility | | $3.55 | $6.92 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $2.95 / $2.95
| Professional | | $2.95 | $2.95 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.95 / $7.24
| Professional | | $2.34 | $2.95 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $4.90 / $4.90
| Facility | | $4.90 | $4.90 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $5.62 / $8.51
| Professional | | $4.90 | $5.62 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $13.18 / $17.78
| Facility | | $3.98 | $13.18 | $17.78 |
- 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
- $4.90 / $6.46 / $7.59
| Facility | | $4.90 | $6.46 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.37 / $7.59
| Professional | | $3.63 | $4.37 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $4.90 / $5.89
| Facility | | $2.95 | $4.90 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.63 / $8.71
| Professional | | $2.24 | $3.63 | $8.71 |