- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $1.15 / $251.19
| Facility | | $1.15 | $1.15 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.51 / $3.89
| Professional | | $1.00 | $1.51 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $0.50 / $1.35
| Professional | | $0.50 | $0.50 | $1.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $1.62 / $50,118.72
| Facility | | $0.62 | $1.62 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.52 / $1.00
| Professional | | $0.52 | $0.52 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $1.74 / $3.98
| Facility | | $1.05 | $1.74 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $1.32 / $2.00
| Professional | | $0.68 | $1.32 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.76 / $0.76 / $0.79
| Facility | | $0.76 | $0.76 | $0.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.72 / $0.76
| Professional | | $0.68 | $0.72 | $0.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $50,118.72 / $75,857.76
| Facility | | $1.62 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $1.00 / $1.00
| Professional | | $0.68 | $1.00 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $0.50 / $2.88
| Facility | | $0.32 | $0.50 | $2.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.51 / $1.29 / $2.40
| Professional | | $0.51 | $1.29 | $2.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.76 / $0.83
| Facility | | $0.68 | $0.76 | $0.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.72 / $0.76
| Professional | | $0.68 | $0.72 | $0.76 |