- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.89 / $5.50
| Facility | | $2.00 | $3.89 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $2.09 / $3.98
| Professional | | $1.32 | $2.09 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.24 / $3.24
| Professional | | $3.24 | $3.24 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.98 / $6.92
| Professional | | $2.57 | $3.98 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.07 / $4.07
| Facility | | $3.80 | $4.07 | $4.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.07 / $4.07
| Professional | | $4.07 | $4.07 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $3.09 / $53,703.18
| Facility | | $2.95 | $3.09 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $2.45 / $5.62
| Professional | | $2.45 | $2.45 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $8.13 / $19.05
| Facility | | $4.90 | $8.13 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.90 / $9.33
| Professional | | $3.09 | $4.90 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $3.63 / $3.89
| Facility | | $3.63 | $3.63 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $3.63
| Professional | | $3.47 | $3.47 | $3.63 |
- 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
- $7.94 / $50,118.72 / $75,857.76
| Facility | | $7.94 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.79 / $4.79
| Professional | | $3.24 | $4.79 | $4.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $2.00 / $4.90
| Facility | | $1.70 | $2.00 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $3.24 / $8.13
| Professional | | $1.74 | $3.24 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $3.89
| Facility | | $3.47 | $3.47 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $3.63
| Professional | | $3.47 | $3.47 | $3.63 |