- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.40 / $14.13
| Facility | | $1.00 | $2.40 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $2.63
| Professional | | $1.00 | $1.00 | $2.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $2.04 / $2.04
| Professional | | $1.58 | $2.04 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.09 / $3.09
| Professional | | $3.09 | $3.09 | $3.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $1.86 / $2.95
| Facility | | $1.86 | $1.86 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $1.58 / $2.19
| Professional | | $1.58 | $1.58 | $2.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $4.17 / $6.03
| Professional | | $2.88 | $4.17 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.16 / $3.16
| Facility | | $3.16 | $3.16 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $2.19 / $3.16
| Professional | | $1.91 | $2.19 | $3.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $6.17
| Facility | | $6.17 | $6.17 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.04 / $2.04
| Professional | | $2.04 | $2.04 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.75 / $7.08
| Facility | | $1.00 | $2.75 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $2.00
| Professional | | $1.00 | $1.00 | $2.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $4.37 / $6.17
| Professional | | $0.60 | $4.37 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.19 / $5.25
| Facility | | $2.09 | $2.19 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.19 / $3.02
| Professional | | $2.09 | $2.19 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $1.41 / $1.95
| Facility | | $1.05 | $1.41 | $1.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.55 / $3.24
| Professional | | $1.07 | $1.55 | $3.24 |