- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $2.51 / $2.51
| Facility | | $1.78 | $2.51 | $2.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.51 / $3.55
| Professional | | $1.00 | $2.51 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.89 / $1.82
| Professional | | $0.68 | $0.89 | $1.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.87 / $83.18 / $131.83
| Professional | | $0.87 | $83.18 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $1.95 / $21.38
| Facility | | $1.74 | $1.95 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $2.04 / $8,709.64
| Professional | | $1.74 | $2.04 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.82 / $8.13
| Professional | | $1.38 | $1.82 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $30.20 / $72.44
| Professional | | $1.38 | $30.20 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.72 / $1.45 / $1.91
| Professional | | $0.72 | $1.45 | $1.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.68 / $2.40
| Facility | | $0.68 | $0.68 | $2.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.89 / $0.95 / $1.58
| Professional | | $0.89 | $0.95 | $1.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.87 / $0.89 / $0.89
| Facility | | $0.87 | $0.89 | $0.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.87 / $0.89
| Professional | | $0.71 | $0.87 | $0.89 |