- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $63.10 / $794.33
| Facility | | $7.08 | $63.10 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $19.95 / $44.67
| Professional | | $1.48 | $19.95 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $3.16 / $5.89
| Facility | | $1.26 | $3.16 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.69 / $0.69 / $0.69
| Professional | | $0.69 | $0.69 | $0.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $6.92 / $20.89
| Facility | | $0.68 | $6.92 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $31.62
| Facility | | $31.62 | $31.62 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.54 / $1.15 / $3.24
| Facility | | $0.54 | $1.15 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.48 / $0.48 / $0.48
| Professional | | $0.48 | $0.48 | $0.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $100.00 / $100.00
| Facility | | $85.11 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $64.57 / $691.83
| Facility | | $3.47 | $64.57 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.48 / $1.20 / $20.89
| Professional | | $0.48 | $1.20 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.37 / $0.37 / $0.39
| Professional | | $0.37 | $0.37 | $0.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.76 / $1.51
| Facility | | $0.52 | $0.76 | $1.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.48 / $0.48 / $0.48
| Professional | | $0.48 | $0.48 | $0.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.48 / $0.65 / $0.65
| Facility | | $0.48 | $0.65 | $0.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.39 / $0.52 / $0.52
| Professional | | $0.39 | $0.52 | $0.52 |