- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $72.44 / $269.15
| Facility | | $2.69 | $72.44 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $39.81
| Professional | | $1.00 | $1.00 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $2.51 / $2.57
| Professional | | $1.02 | $2.51 | $2.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $3.09 / $9.33
| Facility | | $1.58 | $3.09 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $1.78 / $2.75
| Professional | | $1.45 | $1.78 | $2.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $1.48 / $1.48
| Facility | | $1.48 | $1.48 | $1.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $2.00 / $3.47
| Professional | | $1.48 | $2.00 | $3.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.09 / $4.79
| Facility | | $2.75 | $3.09 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $1.45 / $2.95
| Professional | | $1.45 | $1.45 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $3.89 / $20.42
| Facility | | $1.07 | $3.89 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $1.45 / $3.24
| Professional | | $1.45 | $1.45 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $1.82 / $2.69
| Professional | | $1.48 | $1.82 | $2.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $2.45 / $3.39
| Professional | | $1.51 | $2.45 | $3.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $3.24 / $6.31
| Facility | | $1.82 | $3.24 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $1.45 / $1.62
| Professional | | $1.45 | $1.45 | $1.62 |