- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $9.33 / $39.81
| Facility | | $2.00 | $9.33 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $5.89 / $21.38
| Professional | | $1.32 | $5.89 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.89 / $0.89 / $0.89
| Professional | | $0.89 | $0.89 | $0.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $1.17
| Facility | | $1.12 | $1.12 | $1.17 |
- 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
- $0.98 / $1.17 / $1.38
| Facility | | $0.98 | $1.17 | $1.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.89 / $0.89 / $3.55
| Professional | | $0.89 | $0.89 | $3.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.83 / $1.10 / $3.02
| Facility | | $0.83 | $1.10 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.98 / $0.98 / $1.55
| Professional | | $0.98 | $0.98 | $1.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.83 / $0.83 / $0.87
| Facility | | $0.83 | $0.83 | $0.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.83 / $0.83 / $0.87
| Professional | | $0.83 | $0.83 | $0.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.87 / $1.91 / $6.03
| Facility | | $0.87 | $1.91 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $6.03
| Professional | | $1.00 | $1.00 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $50,118.72 / $75,857.76
| Facility | | $1.10 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $0.95 / $1.86
| Facility | | $0.95 | $0.95 | $1.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.74 / $0.79 / $3.80
| Professional | | $0.74 | $0.79 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.83 / $0.83 / $1.00
| Facility | | $0.83 | $0.83 | $1.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.83 / $0.87 / $1.78
| Professional | | $0.83 | $0.87 | $1.78 |