- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $36.31 / $97.72
| Facility | | $7.08 | $36.31 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $30.90 / $30.90
| Professional | | $30.90 | $30.90 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.11 / $0.33
| Facility | | $0.05 | $0.11 | $0.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.06 / $0.10
| Professional | | $0.05 | $0.06 | $0.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.07 / $0.07 / $0.07
| Facility | | $0.07 | $0.07 | $0.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.06 / $0.06 / $0.06
| Facility | | $0.06 | $0.06 | $0.06 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.08 / $0.08 / $0.08
| Professional | | $0.08 | $0.08 | $0.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.10 / $0.11 / $0.18
| Facility | | $0.10 | $0.11 | $0.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.05 / $0.13
| Professional | | $0.05 | $0.05 | $0.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.06 / $0.38 / $1.35
| Facility | | $0.06 | $0.38 | $1.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.06 / $0.06 / $0.17
| Professional | | $0.06 | $0.06 | $0.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.06 / $0.07 / $0.08
| Professional | | $0.06 | $0.07 | $0.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.08 / $0.12
| Professional | | $0.05 | $0.08 | $0.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.06 / $0.11 / $0.11
| Facility | | $0.06 | $0.11 | $0.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.06 / $0.06
| Professional | | $0.05 | $0.06 | $0.06 |