- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $7.76 / $933.25
| Facility | | $2.69 | $7.76 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.69 / $97.72
| Professional | | $2.00 | $2.69 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $2.75 / $3.89
| Facility | | $2.75 | $2.75 | $3.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $2.88 / $5,011.87
| Facility | | $2.45 | $2.88 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $2.75 / $2.75
| Professional | | $2.75 | $2.75 | $2.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $7.94 / $8.51
| Facility | | $2.24 | $7.94 | $8.51 |
- 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
- $2.34 / $2.34 / $3.02
| Professional | | $2.34 | $2.34 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.24 / $2.24
| Facility | | $2.14 | $2.24 | $2.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $4.47 / $53.70
| Professional | | $2.29 | $4.47 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $67.61 / $190.55
| Facility | | $3.55 | $67.61 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $2.82 / $3.16
| Professional | | $2.82 | $2.82 | $3.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $2.75 / $4.07
| Facility | | $2.75 | $2.75 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.47 / $75.86
| Facility | | $2.24 | $3.47 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.00 / $4.37
| Professional | | $2.00 | $2.00 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $77.62 / $100.00
| Professional | | $0.60 | $77.62 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.24 / $8.91
| Facility | | $3.24 | $3.24 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $7.94 / $8.91
| Professional | | $3.24 | $7.94 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $1.58 / $1.58
| Facility | | $1.58 | $1.58 | $1.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $2.69 / $3.47
| Professional | | $1.82 | $2.69 | $3.47 |