- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $4.68 / $794.33
| Facility | | $1.17 | $4.68 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $2.45 / $74.13
| Professional | | $1.07 | $2.45 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $23.99 / $81.28
| Facility | | $8.71 | $23.99 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.04 / $2.04
| Professional | | $2.04 | $2.04 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $0.65 / $79.43
| Facility | | $0.65 | $0.65 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $2.63 / $6.76
| Facility | | $1.20 | $2.63 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1.00
| Professional | | $1.00 | $1.00 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $1,905.46 / $1,905.46
| Professional | | $1,905.46 | $1,905.46 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $1.00 / $33.88
| Facility | | $0.65 | $1.00 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $1.95 / $40.74
| Professional | | $1.05 | $1.95 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $1.86 / $2.45
| Professional | | $1.58 | $1.86 | $2.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $30.20 / $69.18
| Professional | | $1.07 | $30.20 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $0.98 / $33.11
| Facility | | $0.65 | $0.98 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1.48
| Professional | | $1.00 | $1.00 | $1.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.95 / $2.95
| Facility | | $2.14 | $2.95 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $0.72 / $1.91
| Professional | | $0.65 | $0.72 | $1.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.59 / $0.65 / $0.89
| Professional | | $0.59 | $0.65 | $0.89 |