- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $32.36 / $72.44
| Facility | | $4.27 | $32.36 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $9.12 / $77.62
| Professional | | $1.00 | $9.12 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $87.10 / $91.20
| Professional | | $1.48 | $87.10 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.32 / $1.32
| Professional | | $1.26 | $1.32 | $1.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.85 / $0.85 / $0.85
| Professional | | $0.85 | $0.85 | $0.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.82 / $1.82
| Professional | | $1.82 | $1.82 | $1.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.26 / $1.26
| Facility | | $1.26 | $1.26 | $1.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.81 / $1.32 / $2.19
| Professional | | $0.81 | $1.32 | $2.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $2.45 / $3.39
| Facility | | $2.40 | $2.45 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $1.86 / $2.19
| Professional | | $1.70 | $1.86 | $2.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $7.08
| Professional | | $1.00 | $1.00 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.78 / $1.12
| Facility | | $0.56 | $0.78 | $1.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.76 / $1.12 / $3.39
| Professional | | $0.76 | $1.12 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.81 / $1.23 / $2.00
| Professional | | $0.81 | $1.23 | $2.00 |