- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $6.17 / $446.68
| Facility | | $2.00 | $6.17 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.24 / $95.50
| Professional | | $1.00 | $2.24 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $1.82 / $2.57
| Professional | | $1.51 | $1.82 | $2.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $7.94 / $213.80
| Professional | | $1.74 | $7.94 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $2.45 / $107.15
| Facility | | $1.41 | $2.45 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.95 / $537.03
| Professional | | $1.41 | $1.95 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.57 / $3.98
| Professional | | $1.95 | $2.57 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $6.46 / $7.08
| Professional | | $2.69 | $6.46 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $3.16 / $3.80
| Professional | | $1.66 | $3.16 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $30.20
| Facility | | $2.69 | $2.69 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $1.91 / $32.36
| Professional | | $1.78 | $1.91 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $1.95 / $1.95
| Facility | | $1.91 | $1.95 | $1.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $1.91 / $1.95
| Professional | | $1.55 | $1.91 | $1.95 |