- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $67.61 / $602.56
| Facility | | $2.82 | $67.61 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $50.12 / $416.87
| Professional | | $2.00 | $50.12 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $2.88 / $2.88
| Professional | | $2.88 | $2.88 | $2.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $64.57
| Facility | | $61.66 | $61.66 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $61.66
| Professional | | $61.66 | $61.66 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.80 / $63.10
| Facility | | $3.16 | $3.80 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $2.88 / $67.61
| Professional | | $2.88 | $2.88 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.55 / $10.00
| Facility | | $2.75 | $3.55 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.16 / $5.50
| Professional | | $3.16 | $3.16 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $3.16
| Facility | | $3.02 | $3.02 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $3.16
| Professional | | $3.02 | $3.02 | $3.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.01 / $95.50
| Facility | | $3.02 | $5.01 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $50,118.72 / $75,857.76
| Facility | | $3.72 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $4.79 / $9.55
| Facility | | $4.79 | $4.79 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.16 / $36.31
| Professional | | $2.69 | $3.16 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $3.63
| Facility | | $3.02 | $3.02 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.16 / $56.23
| Professional | | $3.02 | $3.16 | $56.23 |