- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $77.62 / $977.24
| Facility | | $2.14 | $77.62 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $3.80 / $69.18
| Professional | | $1.00 | $3.80 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $1.95 / $2.04
| Professional | | $1.70 | $1.95 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.14 / $5.37
| Facility | | $2.09 | $2.14 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.29 / $4.17
| Professional | | $2.04 | $2.29 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $2.29 / $2.29
| Professional | | $2.29 | $2.29 | $2.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $4.57 / $6.03
| Facility | | $2.88 | $4.57 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.04 / $2.34
| Professional | | $2.04 | $2.04 | $2.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $2.40 / $6.17
| Facility | | $1.74 | $2.40 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $1.86 / $60.26
| Professional | | $1.74 | $1.86 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $2.95 / $3.47
| Facility | | $2.95 | $2.95 | $3.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.19 / $3.16
| Professional | | $1.86 | $2.19 | $3.16 |