- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $120.23 / $323.59
| Facility | | $32.36 | $120.23 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $22.91 / $51.29
| Professional | | $2.51 | $22.91 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.14 / $0.15
| Professional | | $0.11 | $0.14 | $0.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.20 / $2.95
| Professional | | $0.11 | $0.20 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.14 / $0.20 / $4.79
| Facility | | $0.14 | $0.20 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.12 / $0.12 / $0.38
| Professional | | $0.12 | $0.12 | $0.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.14 / $0.15 / $0.20
| Professional | | $0.14 | $0.15 | $0.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $0.17 / $0.17
| Professional | | $0.17 | $0.17 | $0.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $1,737.80 / $2,454.71
| Facility | | $338.84 | $1,737.80 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.10 / $0.16 / $0.22
| Professional | | $0.10 | $0.16 | $0.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.20 / $0.20 / $0.20
| Facility | | $0.20 | $0.20 | $0.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.10 / $0.10 / $0.12
| Professional | | $0.10 | $0.10 | $0.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.08 / $0.10 / $0.11
| Professional | | $0.08 | $0.10 | $0.11 |