- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $2,511.89 / $10,715.19
| Facility | | $28.18 | $2,511.89 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $7.08 / $3,162.28
| Professional | | $2.00 | $7.08 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $9.77 / $17.38
| Facility | | $8.51 | $9.77 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $3.09 / $9.77
| Professional | | $1.20 | $3.09 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $1.86 / $10.47
| Facility | | $1.86 | $1.86 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $9.12 / $12.30
| Professional | | $5.89 | $9.12 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $10.23 / $17.38
| Facility | | $2.09 | $10.23 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.26 / $3.89
| Professional | | $1.26 | $1.26 | $3.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $5.89 / $41.69
| Facility | | $2.82 | $5.89 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $1.58 / $3.02
| Professional | | $1.58 | $1.58 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $8.51 / $32.36
| Professional | | $6.76 | $8.51 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $11.22
| Facility | | $11.22 | $11.22 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $8.91 / $18.62
| Professional | | $6.61 | $8.91 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $9.33 / $12.88
| Facility | | $3.02 | $9.33 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.82 / $5.75
| Professional | | $1.26 | $1.82 | $5.75 |