- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.89 / $37.15 / $56.23
| Facility | | $0.89 | $37.15 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1.00
| Professional | | $1.00 | $1.00 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.04 / $0.13
| Facility | | $0.02 | $0.04 | $0.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.02 / $0.13
| Professional | | $0.02 | $0.02 | $0.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.03 / $0.03 / $0.03
| Facility | | $0.03 | $0.03 | $0.03 |
- 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
- $0.05 / $0.05 / $0.05
| Professional | | $0.05 | $0.05 | $0.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.04 / $0.04 / $0.07
| Facility | | $0.04 | $0.04 | $0.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.02 / $0.04
| Professional | | $0.02 | $0.02 | $0.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.04 / $0.12 / $0.24
| Facility | | $0.04 | $0.12 | $0.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.12 / $0.12 / $0.20
| Professional | | $0.12 | $0.12 | $0.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.04 / $0.05 / $0.16
| Professional | | $0.04 | $0.05 | $0.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.03 / $0.05
| Professional | | $0.02 | $0.03 | $0.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.09 / $0.09
| Facility | | $0.05 | $0.09 | $0.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.04 / $0.12 / $0.13
| Professional | | $0.04 | $0.12 | $0.13 |