- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $6,606.93 / $20,892.96
| Facility | | $2,290.87 | $6,606.93 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.00 / $38.90
| Professional | | $2.00 | $2.00 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.89 / $12.30
| Facility | | $3.02 | $3.89 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.94 / $9.33
| Professional | | $7.08 | $7.94 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $14.79 / $22.91
| Facility | | $2.69 | $14.79 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.26 / $9.33
| Professional | | $1.26 | $1.26 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.33 / $75.86
| Professional | | $9.12 | $9.33 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $9.55
| Facility | | $8.91 | $8.91 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $14.13 / $29.51
| Facility | | $4.47 | $14.13 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $10.72
| Professional | | $7.94 | $7.94 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.47 / $24.55
| Facility | | $3.89 | $4.47 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.94 / $9.33
| Professional | | $7.08 | $7.94 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $3.63 / $9.12
| Facility | | $1.05 | $3.63 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.26 / $8.91
| Professional | | $1.26 | $1.26 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.79 / $16.98
| Professional | | $4.17 | $4.79 | $16.98 |