- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $10.47 / $870.96
| Facility | | $3.31 | $10.47 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $4.37 / $10.96
| Professional | | $2.00 | $4.37 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $8.51
| Facility | | $3.31 | $3.31 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $2.00 / $6.31
| Professional | | $1.32 | $2.00 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $3.31 / $3.31
| Facility | | $1.95 | $3.31 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $3.31 / $3.31
| Professional | | $2.40 | $3.31 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $7.94 / $23.44
| Facility | | $3.24 | $7.94 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $4.17 / $15.85
| Professional | | $1.86 | $4.17 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $3.31 / $9.12
| Facility | | $1.41 | $3.31 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $2.29 / $6.17
| Professional | | $1.55 | $2.29 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.09 / $3.89
| Professional | | $2.19 | $3.09 | $3.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $8.32 / $16.22
| Facility | | $3.31 | $8.32 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $2.19 / $2.29
| Professional | | $2.19 | $2.19 | $2.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $6.17 / $50,118.72
| Facility | | $2.95 | $6.17 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $3.39 / $4.47
| Facility | | $1.95 | $3.39 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $2.45 / $7.41
| Professional | | $1.48 | $2.45 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.80 / $8.71
| Facility | | $2.00 | $3.80 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.31 / $21.88
| Professional | | $2.19 | $3.31 | $21.88 |