- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1.12
| Facility | | $1.00 | $1.00 | $1.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1.70
| Professional | | $1.00 | $1.00 | $1.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.20 / $1.45
| Facility | | $1.10 | $1.20 | $1.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $1.23 / $1.23
| Professional | | $1.23 | $1.23 | $1.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.34 / $79.43
| Facility | | $2.34 | $2.34 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $1.45
| Facility | | $1.38 | $1.38 | $1.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.15 / $1.15
| Professional | | $1.00 | $1.15 | $1.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $85.11 / $85.11
| Facility | | $79.43 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $17.38 / $17.38
| Professional | | $14.79 | $17.38 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.95 / $3.31
| Facility | | $1.07 | $1.95 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $2.34
| Professional | | $1.00 | $1.00 | $2.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.35 / $1.55
| Professional | | $1.35 | $1.35 | $1.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $1.91 / $3.24
| Facility | | $1.15 | $1.91 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.15 / $1.15
| Professional | | $1.00 | $1.15 | $1.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.78 / $0.98 / $1.48
| Facility | | $0.78 | $0.98 | $1.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.85 / $1.12 / $1.48
| Professional | | $0.85 | $1.12 | $1.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $2.34 / $2.34
| Professional | | $1.15 | $2.34 | $2.34 |