- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $5.25 / $7.41
| Facility | | $2.00 | $5.25 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.98 / $6.03
| Professional | | $2.00 | $3.98 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.88 / $7.76
| Professional | | $1.86 | $2.88 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.50 / $5.50
| Facility | | $5.01 | $5.50 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $5.50
| Professional | | $5.50 | $5.50 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $10.47 / $53,703.18
| Facility | | $10.47 | $10.47 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $3.39 / $6.92
| Professional | | $3.39 | $3.39 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $10.96 / $25.70
| Facility | | $6.61 | $10.96 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $9.12 / $12.88
| Professional | | $4.57 | $9.12 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $1.32 / $1.41
| Facility | | $1.32 | $1.32 | $1.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $3.80 / $3.98
| Professional | | $1.32 | $3.80 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $50,118.72 / $75,857.76
| Facility | | $2.88 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.31 / $6.31
| Professional | | $4.37 | $6.31 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $25.12
| Facility | | $18.62 | $18.62 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $5.62 / $12.02
| Professional | | $2.75 | $5.62 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $3.72 / $3.80
| Facility | | $1.32 | $3.72 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $3.80 / $3.98
| Professional | | $1.32 | $3.80 | $3.98 |