- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $104.71 / $741.31
| Facility | | $38.02 | $104.71 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.17 / $6.17
| Professional | | $5.01 | $6.17 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.12 / $0.12 / $0.12
| Professional | | $0.12 | $0.12 | $0.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.14 / $0.17 / $0.63
| Facility | | $0.14 | $0.17 | $0.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.12 / $0.12 / $3.09
| Professional | | $0.12 | $0.12 | $3.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.12 / $0.16 / $0.43
| Facility | | $0.12 | $0.16 | $0.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.13 / $0.13 / $0.31
| Professional | | $0.13 | $0.13 | $0.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $3.24 / $3.24
| Facility | | $0.18 | $3.24 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $0.18 / $3.24
| Professional | | $0.17 | $0.18 | $3.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.10 / $0.13 / $0.32
| Facility | | $0.10 | $0.13 | $0.32 |
- 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
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.16 / $0.32
| Facility | | $0.16 | $0.16 | $0.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.17 / $2.95
| Professional | | $0.15 | $0.17 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $2.95 / $3.24
| Facility | | $0.17 | $2.95 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $0.18 / $3.89
| Professional | | $0.17 | $0.18 | $3.89 |