- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $22.39 / $229.09
| Facility | | $3.24 | $22.39 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.85 / $2.45 / $8.13
| Professional | | $0.85 | $2.45 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $42.66 / $97.72
| Professional | | $1.05 | $42.66 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.47 / $0.49 / $0.71
| Facility | | $0.47 | $0.49 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.46 / $0.47 / $2.29
| Professional | | $0.46 | $0.47 | $2.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.72 / $1.15
| Facility | | $0.62 | $0.72 | $1.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $0.65 / $1.48
| Professional | | $0.50 | $0.65 | $1.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $0.76 / $1.00
| Facility | | $0.45 | $0.76 | $1.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.43 / $0.45
| Professional | | $0.43 | $0.43 | $0.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.39 / $0.51 / $1.05
| Professional | | $0.39 | $0.51 | $1.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $123.03 / $123.03
| Facility | | $123.03 | $123.03 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.46 / $0.63 / $8.51
| Professional | | $0.46 | $0.63 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $0.45 / $0.45
| Professional | | $0.45 | $0.45 | $0.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $0.79 / $1.38
| Facility | | $0.45 | $0.79 | $1.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.43 / $0.93
| Professional | | $0.43 | $0.43 | $0.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $1.12
| Professional | | $1.12 | $1.12 | $1.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.34 / $0.47 / $0.72
| Professional | | $0.34 | $0.47 | $0.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $1.78 / $1.78
| Facility | | $1.78 | $1.78 | $1.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.46 / $0.46 / $1.70
| Professional | | $0.46 | $0.46 | $1.70 |