- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $3.09 / $4.37
| Facility | | $1.00 | $3.09 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.00 / $3.63
| Professional | | $1.00 | $2.00 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.82 / $5.50
| Professional | | $2.04 | $2.82 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.24 / $3.24
| Facility | | $3.02 | $3.24 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.24 / $3.24
| Professional | | $3.24 | $3.24 | $3.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $2.45 / $53,703.18
| Facility | | $2.29 | $2.45 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $1.95 / $4.47
| Professional | | $1.95 | $1.95 | $4.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $6.46 / $15.14
| Facility | | $3.89 | $6.46 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.89 / $7.41
| Professional | | $2.24 | $3.89 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $2.63 / $2.75
| Facility | | $2.63 | $2.63 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $2.75 / $2.75
| Professional | | $2.63 | $2.75 | $2.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $50,118.72 / $75,857.76
| Facility | | $5.62 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.80 / $3.80
| Professional | | $2.57 | $3.80 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.58 / $3.89
| Facility | | $1.35 | $1.58 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $2.51 / $6.46
| Professional | | $1.38 | $2.51 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $2.75 / $2.75
| Facility | | $2.63 | $2.75 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $2.75 / $2.75
| Professional | | $2.63 | $2.75 | $2.75 |