- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $2.69 / $93.33
| Facility | | $1.05 | $2.69 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $25.70
| Professional | | $1.00 | $1.00 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $1.15 / $1.15
| Professional | | $1.15 | $1.15 | $1.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.85 / $1.51 / $85.11
| Facility | | $0.85 | $1.51 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $1.15 / $1.41
| Professional | | $1.15 | $1.15 | $1.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.41 / $3.98
| Facility | | $1.26 | $1.41 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.26 / $1.26
| Professional | | $1.07 | $1.26 | $1.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $0.95 / $1.00
| Facility | | $0.95 | $0.95 | $1.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $1.00 / $1.00
| Professional | | $0.95 | $1.00 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $5.25
| Facility | | $3.47 | $3.47 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $1.17 / $2.04
| Professional | | $0.95 | $1.17 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50,118.72 / $50,118.72 / $53,703.18
| Facility | | $50,118.72 | $50,118.72 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.04 / $1.95
| Professional | | $0.02 | $0.04 | $1.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1.00
| Facility | | $1.00 | $1.00 | $1.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $1.45 / $2.04
| Professional | | $1.02 | $1.45 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $0.95 / $1.05
| Facility | | $0.95 | $0.95 | $1.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $1.00 / $1.00
| Professional | | $0.95 | $1.00 | $1.00 |