- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $3.39 / $4,897.79
| Facility | | $1.15 | $3.39 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1,412.54
| Professional | | $1.00 | $1.00 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $2.45
| Facility | | $1.38 | $1.38 | $2.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.10 / $1.38
| Professional | | $1.10 | $1.10 | $1.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $2.69 / $3.98
| Facility | | $1.45 | $2.69 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.41 / $2.04
| Professional | | $1.10 | $1.41 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.12 / $2.14
| Facility | | $1.00 | $1.12 | $2.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $2.24 / $2.24
| Professional | | $1.66 | $2.24 | $2.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $3.31
| Facility | | $1.12 | $1.12 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $2.24
| Professional | | $1.12 | $1.12 | $2.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $64.57 / $85.11
| Professional | | $1.12 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $1.23 / $1.23
| Facility | | $1.17 | $1.23 | $1.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.32 / $3.02
| Professional | | $1.10 | $1.32 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $85.11
| Facility | | $1.12 | $1.12 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $1.12
| Professional | | $1.12 | $1.12 | $1.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.48 / $1.82
| Professional | | $1.35 | $1.48 | $1.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.12 / $2.63
| Facility | | $1.10 | $1.12 | $2.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $1.58
| Professional | | $1.12 | $1.12 | $1.58 |