- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $6.17 / $100.00
| Facility | | $2.29 | $6.17 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.00 / $33.88
| Professional | | $2.00 | $2.00 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.29 / $2.29
| Professional | | $2.09 | $2.29 | $2.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56,234.13 / $69,183.10 / $81,283.05
| Facility | | $56,234.13 | $69,183.10 | $81,283.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $1.70 / $2.75
| Professional | | $1.70 | $1.70 | $2.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $2.19 / $4.37
| Facility | | $2.19 | $2.19 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $2.19 / $2.19
| Professional | | $2.19 | $2.19 | $2.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.95 / $4.68
| Professional | | $2.69 | $2.95 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.29 / $5.37
| Facility | | $2.04 | $2.29 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $2.19 / $3.39
| Professional | | $2.19 | $2.19 | $3.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $2.88 / $3.47
| Facility | | $2.19 | $2.88 | $3.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.88 / $3.02
| Professional | | $2.09 | $2.88 | $3.02 |