- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $8.91 / $33.11
| Facility | | $2.04 | $8.91 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.19 / $8.91
| Professional | | $1.00 | $2.19 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $17.78 / $5,011.87
| Facility | | $13.49 | $17.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.00 / $2.40
| Professional | | $2.00 | $2.00 | $2.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $3.98 / $8.91
| Facility | | $1.82 | $3.98 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $3.16 / $5.37
| Professional | | $1.55 | $3.16 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $2.51 / $3.72
| Professional | | $1.20 | $2.51 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.51 / $5.01
| Facility | | $2.51 | $2.51 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.82 / $4.37
| Professional | | $2.51 | $2.82 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $5.62 / $13.49
| Facility | | $3.47 | $5.62 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $1.91 / $2.09
| Professional | | $1.51 | $1.91 | $2.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $3.80 / $8.71
| Facility | | $1.78 | $3.80 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.00 / $3.89
| Professional | | $1.00 | $2.00 | $3.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $6.17
| Facility | | $3.98 | $3.98 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.89 / $3.39 / $11.75
| Facility | | $0.89 | $3.39 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.89 / $2.51 / $3.63
| Professional | | $0.89 | $2.51 | $3.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $2.51 / $3.02
| Facility | | $1.48 | $2.51 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.91 / $4.47
| Professional | | $1.12 | $1.91 | $4.47 |