- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $16.60 / $81.28
| Facility | | $6.46 | $16.60 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $4.79 / $9.33
| Professional | | $2.82 | $4.79 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.11 / $0.15
| Facility | | $0.11 | $0.11 | $0.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.11 / $0.11
| Professional | | $0.11 | $0.11 | $0.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.11 / $5,011.87
| Facility | | $0.09 | $0.11 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.11 / $0.11
| Professional | | $0.11 | $0.11 | $0.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.10 / $0.35 / $0.38
| Facility | | $0.10 | $0.35 | $0.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.10 / $0.10 / $0.10
| Professional | | $0.10 | $0.10 | $0.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.10 / $0.10 / $0.10
| Facility | | $0.10 | $0.10 | $0.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.17 / $0.17
| Professional | | $0.15 | $0.17 | $0.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.52 / $2.69
| Facility | | $0.28 | $0.52 | $2.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.11 / $0.15
| Facility | | $0.11 | $0.11 | $0.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.11 / $0.11
| Professional | | $0.11 | $0.11 | $0.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.49 / $5.50 / $97.72
| Facility | | $0.49 | $5.50 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.03 / $0.07 / $0.12
| Facility | | $0.03 | $0.07 | $0.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.03 / $0.07 / $0.12
| Professional | | $0.03 | $0.07 | $0.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.10 / $0.10 / $0.18
| Professional | | $0.10 | $0.10 | $0.18 |