- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $13.80 / $52.48
| Facility | | $1.86 | $13.80 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1.00
| Professional | | $1.00 | $1.00 | $1.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.02 / $0.02
| Professional | | $0.02 | $0.02 | $0.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.03 / $0.04
| Facility | | $0.02 | $0.03 | $0.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.02 / $0.43
| Professional | | $0.02 | $0.02 | $0.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.02 / $0.07
| Facility | | $0.02 | $0.02 | $0.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.02 / $0.06
| Professional | | $0.02 | $0.02 | $0.06 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.04 / $0.04 / $0.04
| Facility | | $0.04 | $0.04 | $0.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.04 / $0.04 / $0.04
| Professional | | $0.04 | $0.04 | $0.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.13 / $0.14 / $0.14
| Facility | | $0.13 | $0.14 | $0.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.04 / $50,118.72 / $75,857.76
| Facility | | $0.04 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.04 / $0.04 / $0.09
| Facility | | $0.04 | $0.04 | $0.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.07 / $0.12 / $0.22
| Professional | | $0.07 | $0.12 | $0.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.04 / $0.04 / $0.05
| Facility | | $0.04 | $0.04 | $0.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.03 / $0.04 / $0.05
| Professional | | $0.03 | $0.04 | $0.05 |