- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $56.23 / $147.91
| Facility | | $6.92 | $56.23 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.40 / $2.00 / $7.08
| Professional | | $0.40 | $2.00 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $7.94 / $10.96
| Professional | | $0.09 | $7.94 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.23 / $0.30 / $0.31
| Facility | | $0.23 | $0.30 | $0.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.56 / $0.59
| Professional | | $0.56 | $0.56 | $0.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.40 / $0.40 / $0.40
| Facility | | $0.40 | $0.40 | $0.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.11 / $0.14
| Professional | | $0.11 | $0.11 | $0.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $5.50 / $15.85
| Facility | | $1.20 | $5.50 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.12 / $0.28
| Professional | | $0.09 | $0.12 | $0.28 |
- 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
- $6,025.60 / $7,079.46 / $7,079.46
| Facility | | $6,025.60 | $7,079.46 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.11 / $0.24
| Facility | | $0.09 | $0.11 | $0.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.11 / $0.17
| Professional | | $0.09 | $0.11 | $0.17 |