- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $3.98 / $416.87
| Facility | | $1.78 | $3.98 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.00 / $93.33
| Professional | | $1.00 | $2.00 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $1.74 / $3.16
| Professional | | $1.74 | $1.74 | $3.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.37 / $5.13
| Facility | | $3.80 | $4.37 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $9.77 / $10.23
| Professional | | $9.55 | $9.77 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $1.95 / $3.47
| Professional | | $1.51 | $1.95 | $3.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $2.34 / $125.89
| Facility | | $1.41 | $2.34 | $125.89 |
- 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 / $2.09 / $3.02
| Professional | | $1.95 | $2.09 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $3.47 / $4.07
| Professional | | $2.45 | $3.47 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $2.00 / $4.37
| Facility | | $1.51 | $2.00 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $1.91 / $32.36
| Professional | | $1.62 | $1.91 | $32.36 |