- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $8.71 / $91.20
| Facility | | $3.09 | $8.71 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.85 / $2.14 / $4.90
| Professional | | $0.85 | $2.14 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $45.71 / $45.71
| Professional | | $37.15 | $45.71 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.46 / $0.91 / $2.82
| Facility | | $0.46 | $0.91 | $2.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.50 / $0.85
| Professional | | $0.43 | $0.50 | $0.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.58 / $0.58 / $0.58
| Facility | | $0.58 | $0.58 | $0.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.43 / $0.43
| Facility | | $0.43 | $0.43 | $0.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.58 / $0.58 / $0.58
| Professional | | $0.58 | $0.58 | $0.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.81 / $0.91 / $1.45
| Facility | | $0.81 | $0.91 | $1.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.43 / $0.56
| Professional | | $0.43 | $0.43 | $0.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $3.31 / $13.49
| Facility | | $0.52 | $3.31 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $0.46 / $2.69
| Professional | | $0.45 | $0.46 | $2.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.52 / $0.65
| Professional | | $0.43 | $0.52 | $0.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.40 / $0.72 / $1.00
| Professional | | $0.40 | $0.72 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $1.05 / $1.05
| Facility | | $0.60 | $1.05 | $1.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.46 / $0.46 / $0.60
| Professional | | $0.46 | $0.46 | $0.60 |