- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $52.48 / $281.84
| Facility | | $1.07 | $52.48 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.66 / $32.36
| Professional | | $1.10 | $1.66 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.56 / $0.81
| Facility | | $0.52 | $0.56 | $0.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.55 / $2.19
| Professional | | $0.52 | $0.55 | $2.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $1.91 / $2.29
| Facility | | $1.20 | $1.91 | $2.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.69 / $1.41
| Professional | | $0.52 | $0.69 | $1.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $0.81 / $1.10
| Facility | | $0.50 | $0.81 | $1.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.48 / $0.48 / $0.50
| Professional | | $0.48 | $0.48 | $0.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.58 / $1.20
| Professional | | $0.43 | $0.58 | $1.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $100.00
| Facility | | $85.11 | $85.11 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $0.32 / $0.32
| Professional | | $0.32 | $0.32 | $0.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $0.83 / $1.20
| Facility | | $0.50 | $0.83 | $1.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.48 / $0.48 / $1.23
| Professional | | $0.48 | $0.48 | $1.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1.00
| Professional | | $1.00 | $1.00 | $1.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.52 / $0.81
| Professional | | $0.38 | $0.52 | $0.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.14 / $2.14
| Facility | | $2.14 | $2.14 | $2.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.52 / $1.45
| Professional | | $0.52 | $0.52 | $1.45 |