- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $3.02 / $4.37
| Facility | | $1.00 | $3.02 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.00 / $3.55
| Professional | | $1.00 | $2.00 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.39 / $7.08
| Professional | | $2.00 | $3.39 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $3.16 / $3.16
| Facility | | $2.95 | $3.16 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.16 / $3.16
| Professional | | $3.16 | $3.16 | $3.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $2.82 / $53,703.18
| Facility | | $2.29 | $2.82 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $1.95 / $4.57
| Professional | | $1.95 | $1.95 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $6.31 / $14.79
| Facility | | $3.89 | $6.31 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $4.79 / $7.41
| Professional | | $2.51 | $4.79 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $2.88 / $3.02
| Facility | | $2.88 | $2.88 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $2.75 / $2.88
| Professional | | $2.75 | $2.75 | $2.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $50,118.72 / $75,857.76
| Facility | | $6.17 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.72 / $3.72
| Professional | | $2.51 | $3.72 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $1.58 / $3.89
| Facility | | $1.32 | $1.58 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $2.51 / $6.31
| Professional | | $1.35 | $2.51 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.75 / $3.02
| Facility | | $2.69 | $2.75 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $2.75 / $2.88
| Professional | | $2.75 | $2.75 | $2.88 |