- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $21.88
| Professional | | $1.00 | $1.00 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $2.51 / $4.68
| Professional | | $1.35 | $2.51 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $1.78 / $3.47
| Facility | | $1.51 | $1.78 | $3.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.86 / $2.09
| Professional | | $1.12 | $1.86 | $2.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.76 / $1.00 / $2.88
| Facility | | $0.76 | $1.00 | $2.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.76 / $1.10 / $24.55
| Facility | | $0.76 | $1.10 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $234.42 / $309.03
| Professional | | $8.71 | $234.42 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $54.95 / $85.11
| Professional | | $50.12 | $54.95 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $1.38
| Facility | | $1.38 | $1.38 | $1.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $1.66 / $1.66
| Professional | | $1.66 | $1.66 | $1.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $3.16 / $4.37
| Professional | | $1.48 | $3.16 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $89.13
| Facility | | $1.12 | $1.12 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.95 / $8.71
| Professional | | $1.12 | $1.95 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $1.29 / $3.02
| Facility | | $1.29 | $1.29 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $234.42 / $309.03
| Professional | | $234.42 | $234.42 | $309.03 |