- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $44.67 / $933.25
| Facility | | $2.51 | $44.67 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $1.48
| Professional | | $1.12 | $1.12 | $1.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.42 / $0.45 / $0.62
| Facility | | $0.42 | $0.45 | $0.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.39 / $0.43 / $1.38
| Professional | | $0.39 | $0.43 | $1.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.48 / $0.52 / $0.68
| Facility | | $0.48 | $0.52 | $0.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.52 / $1.15
| Professional | | $0.41 | $0.52 | $1.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.68 / $0.91
| Facility | | $0.41 | $0.68 | $0.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.39 / $0.39 / $0.40
| Professional | | $0.39 | $0.39 | $0.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.45 / $1.00
| Professional | | $0.35 | $0.45 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $204.17 / $204.17
| Facility | | $190.55 | $204.17 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.39 / $0.39 / $0.39
| Professional | | $0.39 | $0.39 | $0.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.39 / $0.68 / $0.98
| Facility | | $0.39 | $0.68 | $0.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.39 / $0.39 / $0.62
| Professional | | $0.39 | $0.39 | $0.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $2.63 / $2.63
| Facility | | $2.63 | $2.63 | $2.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.41 / $1.02
| Professional | | $0.41 | $0.41 | $1.02 |