- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $251.19 / $724.44
| Facility | | $7.76 | $251.19 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $223.87 / $1,995.26
| Professional | | $2.09 | $223.87 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $53.70 / $56.23
| Professional | | $53.70 | $53.70 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.58 / $1.48
| Facility | | $0.56 | $0.58 | $1.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.65 / $1.12
| Professional | | $0.56 | $0.65 | $1.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.62 / $0.62
| Professional | | $0.62 | $0.62 | $0.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.74 / $1.23 / $1.62
| Facility | | $0.74 | $1.23 | $1.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.52 / $0.63
| Professional | | $0.52 | $0.52 | $0.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.56 / $2.40
| Facility | | $0.38 | $0.56 | $2.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.41 / $1,047.13
| Professional | | $0.38 | $0.41 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.81 / $0.81 / $0.95
| Facility | | $0.81 | $0.81 | $0.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.59 / $0.65 / $5.62
| Professional | | $0.59 | $0.65 | $5.62 |