- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $56.23 / $218.78
| Facility | | $1.45 | $56.23 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.45 / $181.97
| Professional | | $1.00 | $2.45 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.62 / $186.21
| Facility | | $1.38 | $1.62 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $1.62 / $1.66
| Professional | | $1.58 | $1.62 | $1.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $1.78 / $2.29
| Professional | | $1.51 | $1.78 | $2.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $4.37 / $446.68
| Facility | | $1.51 | $4.37 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $1.48 / $3.47
| Professional | | $1.48 | $1.48 | $3.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $1.78 / $1.78
| Professional | | $1.70 | $1.78 | $1.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $3.72 / $3.72
| Professional | | $1.70 | $3.72 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,071.52 / $1,122.02
| Facility | | $954.99 | $1,071.52 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $1.82 / $3.98
| Facility | | $1.45 | $1.82 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.45 / $3.47
| Professional | | $1.38 | $1.45 | $3.47 |