- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $22.39 / $83.18
| Facility | | $2.24 | $22.39 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $2.00
| Professional | | $1.00 | $1.00 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $2.88 / $8.71
| Facility | | $1.45 | $2.88 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.58 / $2.57
| Professional | | $1.35 | $1.58 | $2.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.82 / $1.82
| Facility | | $1.82 | $1.82 | $1.82 |
- 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
- $1.86 / $1.86 / $1.86
| Professional | | $1.86 | $1.86 | $1.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $2.88 / $4.47
| Facility | | $2.57 | $2.88 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.35 / $2.14
| Professional | | $1.35 | $1.35 | $2.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $7.76 / $26.30
| Facility | | $1.32 | $7.76 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $1.32 / $7.24
| Professional | | $1.32 | $1.32 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $1.66 / $1.95
| Professional | | $1.32 | $1.66 | $1.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $2.29 / $3.16
| Professional | | $1.26 | $2.29 | $3.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $3.39 / $3.39
| Facility | | $1.91 | $3.39 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $1.32 / $1.74
| Professional | | $1.32 | $1.32 | $1.74 |