- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $5.37 / $11.22
| Facility | | $2.24 | $5.37 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.00 / $8.51
| Professional | | $2.00 | $2.00 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.40 / $5,011.87
| Facility | | $2.04 | $2.40 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $2.29 / $2.29
| Professional | | $2.29 | $2.29 | $2.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $6.17 / $6.61
| Facility | | $1.78 | $6.17 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $1.78 / $2.82
| Professional | | $1.78 | $1.78 | $2.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $16.98 / $18.20
| Professional | | $1.55 | $16.98 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $1.78 / $1.78
| Facility | | $1.78 | $1.78 | $1.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $2.04 / $4.68
| Professional | | $1.78 | $2.04 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $2.69 / $19.50
| Facility | | $1.91 | $2.69 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.00 / $2.00
| Professional | | $1.86 | $2.00 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $4.79 / $9.33
| Facility | | $3.16 | $4.79 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $4.79 / $9.33
| Professional | | $3.16 | $4.79 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.68 / $0.85
| Facility | | $0.02 | $0.68 | $0.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.87 / $2.19 / $3.72
| Professional | | $0.87 | $2.19 | $3.72 |