- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $7.41 / $81.28
| Facility | | $1.35 | $7.41 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $2.29
| Professional | | $1.00 | $1.00 | $2.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.41 / $1.41
| Professional | | $1.41 | $1.41 | $1.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.56 / $50,118.72
| Facility | | $0.56 | $0.56 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $1.45 / $7.59
| Professional | | $1.45 | $1.45 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $0.87 / $1.45
| Facility | | $0.60 | $0.87 | $1.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $0.87 / $1.00
| Professional | | $0.60 | $0.87 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.87 / $0.87 / $0.91
| Facility | | $0.87 | $0.87 | $0.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.87 / $0.87 / $0.87
| Professional | | $0.87 | $0.87 | $0.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $2.95 / $9.77
| Facility | | $1.32 | $2.95 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $50,118.72 / $75,857.76
| Facility | | $3.09 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $2.19 / $2.19
| Facility | | $2.19 | $2.19 | $2.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.41 / $2.69
| Professional | | $1.26 | $1.41 | $2.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.87 / $0.87 / $1.00
| Facility | | $0.87 | $0.87 | $1.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.87 / $1.05
| Professional | | $0.62 | $0.87 | $1.05 |