- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $741.31 / $6,456.54
| Facility | | $467.74 | $741.31 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $263.03 / $1,548.82
| Professional | | $2.04 | $263.03 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $63.10 / $72.44
| Professional | | $61.66 | $63.10 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $22.91 / $43.65
| Facility | | $1.91 | $22.91 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.60 / $0.91
| Professional | | $0.56 | $0.60 | $0.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.76 / $0.78 / $1.35
| Facility | | $0.76 | $0.78 | $1.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.52 / $0.58
| Professional | | $0.52 | $0.52 | $0.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $25.70 / $27.54
| Professional | | $18.62 | $25.70 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $0.85 / $12.88
| Facility | | $0.65 | $0.85 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $1.62 / $30.20
| Professional | | $1.58 | $1.62 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1.00
| Facility | | $1.00 | $1.00 | $1.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.55 / $0.68 / $0.81
| Professional | | $0.55 | $0.68 | $0.81 |