- 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
- $2.00 / $3.98 / $6.17
| Professional | | $2.00 | $3.98 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.68 / $10.00
| Professional | | $3.63 | $4.68 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.75 / $5.75
| Facility | | $5.37 | $5.75 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $5.75
| Professional | | $5.75 | $5.75 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.47 / $53,703.18
| Facility | | $4.17 | $4.47 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $3.55 / $7.94
| Professional | | $3.55 | $3.55 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $11.48 / $26.92
| Facility | | $7.08 | $11.48 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $7.08 / $13.18
| Professional | | $3.89 | $7.08 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $4.57 / $4.79
| Facility | | $4.57 | $4.57 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.01 / $5.01
| Professional | | $4.57 | $5.01 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $4.37
| Professional | | $4.37 | $4.37 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $50,118.72 / $75,857.76
| Facility | | $9.77 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $6.76 / $6.76
| Professional | | $4.57 | $6.76 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $2.95 / $7.08
| Facility | | $2.40 | $2.95 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $4.37 / $12.02
| Professional | | $2.45 | $4.37 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $4.90 / $5.01
| Facility | | $4.57 | $4.90 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.01 / $5.01
| Professional | | $4.57 | $5.01 | $5.01 |