- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $5.50 / $7.76
| Facility | | $2.00 | $5.50 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.98 / $6.46
| Professional | | $2.19 | $3.98 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $10.00
| Professional | | $3.47 | $3.47 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.62 / $5.62
| Facility | | $5.25 | $5.62 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $5.62
| Professional | | $5.62 | $5.62 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $53,703.18
| Facility | | $11.48 | $11.48 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $7.24
| Professional | | $3.80 | $3.80 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $11.48 / $26.92
| Facility | | $6.92 | $11.48 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $10.00 / $13.80
| Professional | | $6.17 | $10.00 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $1.70 / $1.78
| Facility | | $1.70 | $1.70 | $1.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $3.98 / $4.17
| Professional | | $1.70 | $3.98 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $50,118.72 / $75,857.76
| Facility | | $3.63 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $6.61 / $6.61
| Professional | | $4.57 | $6.61 | $6.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $21.38 / $28.18
| Facility | | $19.50 | $21.38 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $6.03 / $12.59
| Professional | | $3.02 | $6.03 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $3.89 / $3.98
| Facility | | $1.70 | $3.89 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $3.98 / $4.17
| Professional | | $1.70 | $3.98 | $4.17 |