- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $229.09 / $1,288.25
| Facility | | $1.95 | $229.09 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $181.97 / $851.14
| Professional | | $1.82 | $181.97 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.71 / $0.71
| Facility | | $0.71 | $0.71 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.56 / $0.71
| Professional | | $0.56 | $0.56 | $0.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.63 / $0.63 / $0.95
| Facility | | $0.63 | $0.63 | $0.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.63 / $0.72 / $1.45
| Professional | | $0.63 | $0.72 | $1.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.78 / $1.07 / $2.24
| Facility | | $0.78 | $1.07 | $2.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.83 / $1.32
| Professional | | $0.52 | $0.83 | $1.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.63 / $0.63 / $1.32
| Facility | | $0.63 | $0.63 | $1.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.81 / $1.26 / $17.38
| Professional | | $0.81 | $1.26 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.39 / $6.31
| Facility | | $0.38 | $0.39 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.52 / $1,047.13
| Professional | | $0.38 | $0.52 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $64.57 / $85.11
| Professional | | $50.12 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.78 / $1.07 / $13.18
| Facility | | $0.78 | $1.07 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.58 / $0.78 / $1.32
| Professional | | $0.58 | $0.78 | $1.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.55 / $1.07 / $2.34
| Professional | | $0.55 | $1.07 | $2.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.63 / $85.11 / $100.00
| Facility | | $0.63 | $85.11 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.63 / $1.41 / $1,047.13
| Professional | | $0.63 | $1.41 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.76 / $1.07 / $2.04
| Professional | | $0.76 | $1.07 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.62 / $1.45
| Facility | | $0.62 | $0.62 | $1.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $0.81 / $87.10
| Professional | | $0.65 | $0.81 | $87.10 |