- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $2.40 / $4.79
| Facility | | $1.62 | $2.40 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $2.69
| Professional | | $1.00 | $1.00 | $2.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $1.86 / $3.31
| Facility | | $1.86 | $1.86 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $1.48 / $1.91
| Professional | | $1.48 | $1.48 | $1.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $3.63 / $5.37
| Facility | | $1.95 | $3.63 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $2.04 / $2.95
| Professional | | $1.48 | $2.04 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.66 / $3.55
| Facility | | $1.00 | $1.66 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.31 / $3.31
| Professional | | $2.51 | $3.31 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.55 / $3.55
| Facility | | $1.00 | $1.55 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $1.55 / $2.45
| Professional | | $1.55 | $1.55 | $2.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $64.57 / $85.11
| Professional | | $64.57 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $1.41
| Facility | | $1.38 | $1.38 | $1.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $1.86 / $5.37
| Professional | | $1.48 | $1.86 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $1.58 / $100.00
| Facility | | $1.58 | $1.58 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $1.58 / $1.58
| Professional | | $1.58 | $1.58 | $1.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $2.00 / $2.45
| Professional | | $1.51 | $2.00 | $2.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $1.48 / $3.47
| Facility | | $1.48 | $1.48 | $3.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $1.58 / $2.24
| Professional | | $1.58 | $1.58 | $2.24 |