- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $4.47 / $32.36
| Facility | | $1.86 | $4.47 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.10 / $2.51
| Professional | | $1.00 | $1.10 | $2.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $117.49 / $251.19
| Facility | | $1.17 | $117.49 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.17 / $5,011.87
| Facility | | $1.00 | $1.17 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $1.12
| Professional | | $1.12 | $1.12 | $1.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $3.31 / $3.55
| Facility | | $0.95 | $3.31 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $0.95 / $0.95
| Professional | | $0.95 | $0.95 | $0.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $0.95 / $0.95
| Facility | | $0.95 | $0.95 | $0.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $1.66 / $1.66
| Professional | | $1.45 | $1.66 | $1.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $6.61 / $10.47
| Facility | | $3.47 | $6.61 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $1.17 / $239.88
| Facility | | $1.17 | $1.17 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.74 / $38.02
| Facility | | $1.00 | $1.74 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1.41
| Professional | | $1.00 | $1.00 | $1.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $3,162.28 / $4,466.84
| Facility | | $2,290.87 | $3,162.28 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.91 / $1.26 / $1.41
| Facility | | $0.91 | $1.26 | $1.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.91 / $1.26 / $1.78
| Professional | | $0.91 | $1.26 | $1.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.20 / $2.00
| Professional | | $1.07 | $1.20 | $2.00 |