- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $3.09 / $6.17
| Facility | | $2.09 | $3.09 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.00 / $3.09
| Professional | | $2.00 | $2.00 | $3.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $4.79
| Facility | | $2.69 | $2.69 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.14 / $2.75
| Professional | | $2.14 | $2.14 | $2.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $7.24 / $15.14
| Facility | | $2.34 | $7.24 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.57 / $4.17
| Professional | | $2.09 | $2.57 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $1.86 / $27.54
| Facility | | $1.86 | $1.86 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.80 / $69.18
| Professional | | $2.00 | $3.80 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $1.86 / $27.54
| Facility | | $1.86 | $1.86 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.04 / $2,344.23
| Professional | | $1.86 | $2.04 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $64.57 / $85.11
| Professional | | $50.12 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $9.77 / $15.85
| Facility | | $1.91 | $9.77 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $1.91 / $15.14
| Professional | | $1.45 | $1.91 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $3.63 / $7.08
| Professional | | $2.14 | $3.63 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $85.11 / $123.03
| Facility | | $2.04 | $85.11 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $4.17 / $2,344.23
| Professional | | $2.04 | $4.17 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $32.36 / $46.77
| Professional | | $2.95 | $32.36 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $1.23 / $2.88
| Facility | | $1.23 | $1.23 | $2.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $2.04 / $5.62
| Professional | | $1.29 | $2.04 | $5.62 |