- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $13.18 / $40.74
| Facility | | $3.47 | $13.18 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.14 / $9.55
| Professional | | $1.86 | $2.14 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $3.31 / $100.00
| Facility | | $2.14 | $3.31 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.34 / $5.75
| Professional | | $2.00 | $2.34 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.75 / $8.32
| Facility | | $4.57 | $5.75 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $2.24 / $3.02
| Professional | | $2.24 | $2.24 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $3.72 / $9.12
| Facility | | $1.86 | $3.72 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $2.63 / $4.17
| Professional | | $1.66 | $2.63 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $3.31 / $4,897.79
| Facility | | $2.40 | $3.31 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.09 / $3.80
| Professional | | $2.63 | $3.09 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.34 / $7.24
| Professional | | $2.34 | $2.34 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.47 / $19.50
| Facility | | $2.82 | $3.47 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $3.31 / $100.00
| Facility | | $2.14 | $3.31 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.34 / $5.75
| Professional | | $2.00 | $2.34 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.69 / $5.62
| Facility | | $2.09 | $2.69 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.40 / $3.55
| Professional | | $2.09 | $2.40 | $3.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $2.34 / $3.89
| Facility | | $1.35 | $2.34 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $2.34 / $6.76
| Professional | | $1.51 | $2.34 | $6.76 |