- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.09 / $562.34
| Facility | | $2.09 | $2.09 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $177.83 / $446.68
| Professional | | $2.09 | $177.83 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.68 / $0.85
| Professional | | $0.52 | $0.68 | $0.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.63 / $2.95 / $28.84
| Professional | | $0.63 | $2.95 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.78 / $23.44
| Facility | | $0.38 | $0.78 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.54 / $1,047.13
| Professional | | $0.38 | $0.54 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.78 / $1.38
| Professional | | $0.56 | $0.78 | $1.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.78 / $3.98 / $5.75
| Professional | | $0.78 | $3.98 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $1.15 / $1.38
| Professional | | $0.60 | $1.15 | $1.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $8.91
| Facility | | $1.00 | $1.00 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $0.68 / $5.62
| Professional | | $0.65 | $0.68 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.69 / $0.71 / $0.71
| Facility | | $0.69 | $0.71 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.69 / $0.71
| Professional | | $0.56 | $0.69 | $0.71 |