- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $331.13 / $1,445.44
| Facility | | $1.82 | $331.13 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $95.50 / $1,778.28
| Professional | | $1.78 | $95.50 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $3.31 / $12.59
| Facility | | $1.07 | $3.31 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.40 / $0.40 / $0.40
| Professional | | $0.40 | $0.40 | $0.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $1.15 / $6.03
| Professional | | $0.32 | $1.15 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $114.82 / $114.82
| Facility | | $114.82 | $114.82 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.49 / $1.07 / $2.75
| Facility | | $0.49 | $1.07 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.41 / $0.41
| Professional | | $0.41 | $0.41 | $0.41 |
- 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
- $602.56 / $602.56 / $602.56
| Professional | | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.46 / $0.60 / $5.75
| Facility | | $0.46 | $0.60 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $1.20 / $588.84
| Professional | | $0.41 | $1.20 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.47 / $0.56 / $0.71
| Professional | | $0.47 | $0.56 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $9.77 / $30.20
| Professional | | $0.60 | $9.77 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.46 / $0.60 / $5.62
| Facility | | $0.46 | $0.60 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.41 / $0.41
| Professional | | $0.41 | $0.41 | $0.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.39 / $0.52 / $0.52
| Facility | | $0.39 | $0.52 | $0.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.34 / $0.46 / $0.51
| Professional | | $0.34 | $0.46 | $0.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.46 / $0.51
| Professional | | $0.41 | $0.46 | $0.51 |