- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $2.75 / $2.75
| Facility | | $1.10 | $2.75 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.57 / $4.17
| Professional | | $1.00 | $2.57 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.42 / $0.42 / $1.35
| Professional | | $0.42 | $0.42 | $1.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $1.51 / $53,703.18
| Facility | | $1.51 | $1.51 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.49 / $0.49 / $1.00
| Professional | | $0.49 | $0.49 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.98 / $1.58 / $3.72
| Facility | | $0.98 | $1.58 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.78 / $1.38 / $1.95
| Professional | | $0.78 | $1.38 | $1.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $0.18 / $0.19
| Facility | | $0.18 | $0.18 | $0.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $0.55 / $0.58
| Professional | | $0.18 | $0.55 | $0.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $50,118.72 / $75,857.76
| Facility | | $0.41 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $0.93 / $0.93
| Professional | | $0.65 | $0.93 | $0.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.75 / $3.63
| Facility | | $2.69 | $2.75 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.40 / $0.78 / $2.04
| Professional | | $0.40 | $0.78 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $0.54 / $0.55
| Facility | | $0.18 | $0.54 | $0.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $0.55 / $0.58
| Professional | | $0.18 | $0.55 | $0.58 |