- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $74.13 / $181.97
| Facility | | $14.79 | $74.13 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $25.70 / $120.23
| Professional | | $6.46 | $25.70 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.19 / $0.44 / $0.69
| Facility | | $0.19 | $0.44 | $0.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.10 / $0.23
| Professional | | $0.09 | $0.10 | $0.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.09 / $0.18
| Facility | | $0.09 | $0.09 | $0.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.21 / $0.46
| Professional | | $0.15 | $0.21 | $0.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.12 / $0.19 / $0.39
| Facility | | $0.12 | $0.19 | $0.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.09 / $0.09
| Professional | | $0.09 | $0.09 | $0.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.13 / $6,918.31
| Facility | | $0.09 | $0.13 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.09 / $0.15
| Professional | | $0.09 | $0.09 | $0.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $181.97 / $275.42
| Facility | | $181.97 | $181.97 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.19 / $0.44 / $0.69
| Facility | | $0.19 | $0.44 | $0.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.10 / $0.23
| Professional | | $0.09 | $0.10 | $0.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.13 / $338.84 / $794.33
| Facility | | $0.13 | $338.84 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.13 / $0.13 / $0.17
| Professional | | $0.13 | $0.13 | $0.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.12 / $0.20 / $0.26
| Facility | | $0.12 | $0.20 | $0.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.10 / $0.20
| Professional | | $0.09 | $0.10 | $0.20 |