- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $85.11 / $173.78
| Facility | | $31.62 | $85.11 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $30.90 / $30.90
| Professional | | $3.02 | $30.90 | $30.90 |
- 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
- $0.05 / $0.05 / $0.06
| Professional | | $0.05 | $0.05 | $0.06 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.09 / $0.15
| Facility | | $0.05 | $0.09 | $0.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.04 / $0.05 / $0.10
| Professional | | $0.04 | $0.05 | $0.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.06 / $0.06 / $0.71
| Facility | | $0.06 | $0.06 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.12 / $0.12
| Professional | | $0.09 | $0.12 | $0.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.52 / $1.62
| Facility | | $0.16 | $0.52 | $1.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.05 / $0.12
| Professional | | $0.05 | $0.05 | $0.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $54.95 / $85.11
| Professional | | $50.12 | $54.95 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.05 / $0.05
| Facility | | $0.05 | $0.05 | $0.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.10 / $1.07
| Professional | | $0.05 | $0.10 | $1.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.06 / $0.06 / $85.11
| Facility | | $0.06 | $0.06 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.06 / $0.06 / $0.06
| Professional | | $0.06 | $0.06 | $0.06 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.07 / $0.07 / $0.68
| Professional | | $0.07 | $0.07 | $0.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.05 / $0.12
| Facility | | $0.05 | $0.05 | $0.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.06 / $0.06 / $0.08
| Professional | | $0.06 | $0.06 | $0.08 |