- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $338.84 / $3,715.35
| Facility | | $1.05 | $338.84 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $12.30
| Professional | | $6.46 | $6.46 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.13 / $0.16 / $0.24
| Facility | | $0.13 | $0.16 | $0.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.17 / $1.70
| Professional | | $0.16 | $0.17 | $1.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.31 / $0.34 / $0.54
| Facility | | $0.31 | $0.34 | $0.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.21 / $0.56
| Professional | | $0.16 | $0.21 | $0.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.13 / $0.21 / $0.28
| Facility | | $0.13 | $0.21 | $0.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.12 / $0.12 / $0.13
| Professional | | $0.12 | $0.12 | $0.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.16 / $1.00
| Professional | | $0.11 | $0.16 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.16 / $0.16
| Professional | | $0.16 | $0.16 | $0.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.13 / $0.23 / $0.52
| Facility | | $0.13 | $0.23 | $0.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.12 / $0.12 / $0.31
| Professional | | $0.12 | $0.12 | $0.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.85 / $0.85 / $0.85
| Professional | | $0.85 | $0.85 | $0.85 |
- 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
- $0.16 / $0.16 / $0.44
| Professional | | $0.16 | $0.16 | $0.44 |