- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $9.12 / $363.08
| Facility | | $2.57 | $9.12 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.70 / $5.62
| Professional | | $1.00 | $1.70 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.29 / $4.07
| Professional | | $1.26 | $1.29 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.55 / $1.95
| Facility | | $1.35 | $1.55 | $1.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $1.35 / $5.01
| Professional | | $1.29 | $1.35 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $4.27 / $5.25
| Facility | | $3.72 | $4.27 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.82 / $4.27
| Professional | | $1.41 | $1.82 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $2.34 / $3.16
| Facility | | $1.41 | $2.34 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.35 / $1.41
| Professional | | $1.35 | $1.35 | $1.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $1.41 / $2.88
| Professional | | $1.15 | $1.41 | $2.88 |
- 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
- $1.26 / $1.26 / $1.26
| Professional | | $1.26 | $1.26 | $1.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $2.04 / $3.39
| Facility | | $1.29 | $2.04 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.35 / $1.86
| Professional | | $1.35 | $1.35 | $1.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $2.24 / $2.24
| Professional | | $2.24 | $2.24 | $2.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.48 / $2.29
| Professional | | $1.07 | $1.48 | $2.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.47 / $4.47
| Facility | | $4.47 | $4.47 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $1.29 / $3.16
| Professional | | $1.29 | $1.29 | $3.16 |