- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.95 / $2.82
| Facility | | $1.00 | $1.95 | $2.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $3.63
| Professional | | $1.00 | $1.00 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.07 / $2.51
| Professional | | $1.07 | $1.07 | $2.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.10 / $3.47
| Professional | | $1.10 | $1.10 | $3.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $2.04 / $2.04
| Facility | | $1.91 | $2.04 | $2.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.04 / $2.04
| Professional | | $2.04 | $2.04 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $53,703.18
| Facility | | $3.98 | $3.98 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.26 / $2.57
| Professional | | $1.26 | $1.26 | $2.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $4.17 / $9.55
| Facility | | $2.51 | $4.17 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.55 / $5.01
| Professional | | $2.24 | $3.55 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.09 / $0.09
| Facility | | $0.09 | $0.09 | $0.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $1.41 / $1.51
| Professional | | $0.09 | $1.41 | $1.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $50,118.72 / $75,857.76
| Facility | | $0.22 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $2.40 / $2.40
| Professional | | $1.62 | $2.40 | $2.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $9.33
| Facility | | $6.92 | $6.92 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $2.19 / $4.57
| Professional | | $1.05 | $2.19 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $1.41 / $1.41
| Facility | | $0.09 | $1.41 | $1.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $1.41 / $1.51
| Professional | | $0.09 | $1.41 | $1.51 |