- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $3.55 / $141.25
| Facility | | $1.00 | $3.55 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.55 / $2.95
| Professional | | $1.00 | $1.55 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $4.79
| Professional | | $1.38 | $1.38 | $4.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $2.57 / $2.57
| Facility | | $2.40 | $2.57 | $2.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $2.57 / $2.57
| Professional | | $2.57 | $2.57 | $2.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.29 / $53,703.18
| Facility | | $1.86 | $2.29 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $1.58 / $3.72
| Professional | | $1.58 | $1.58 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $5.25 / $12.02
| Facility | | $3.16 | $5.25 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.31 / $6.03
| Professional | | $2.00 | $3.31 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.34 / $2.45
| Facility | | $2.34 | $2.34 | $2.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $1.91 / $2.34
| Professional | | $1.78 | $1.91 | $2.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $50,118.72 / $75,857.76
| Facility | | $5.01 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $3.02 / $3.02
| Professional | | $2.04 | $3.02 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.45 / $3.16
| Facility | | $1.00 | $1.45 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $2.04 / $5.37
| Professional | | $1.07 | $2.04 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $2.19 / $2.45
| Facility | | $1.78 | $2.19 | $2.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $1.91 / $2.34
| Professional | | $1.78 | $1.91 | $2.34 |