- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $9.33 / $107.15
| Facility | | $3.55 | $9.33 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.82 / $6.61
| Professional | | $1.00 | $1.82 | $6.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $1.91 / $2.75
| Facility | | $1.70 | $1.91 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $1.82 / $6.03
| Professional | | $1.55 | $1.82 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $4.27
| Facility | | $3.31 | $3.31 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $2.34 / $6.76
| Professional | | $1.82 | $2.34 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $2.69 / $3.63
| Facility | | $1.62 | $2.69 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $1.55 / $1.62
| Professional | | $1.55 | $1.55 | $1.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $2.00 / $4.07
| Professional | | $1.41 | $2.00 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $1.78 / $1.78
| Professional | | $1.78 | $1.78 | $1.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $2.57 / $4.17
| Facility | | $1.55 | $2.57 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $1.55 / $3.39
| Professional | | $1.55 | $1.55 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.47 / $4.47
| Professional | | $4.47 | $4.47 | $4.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $10.23
| Facility | | $10.23 | $10.23 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.82 / $4.90
| Professional | | $1.82 | $1.82 | $4.90 |