- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $478.63 / $758.58
| Facility | | $34.67 | $478.63 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $41.69 / $67.61
| Professional | | $28.18 | $41.69 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $22.91
| Professional | | $10.96 | $10.96 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.11 / $0.12
| Facility | | $0.09 | $0.11 | $0.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.12 / $0.13 / $0.13
| Professional | | $0.12 | $0.13 | $0.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.14 / $0.20
| Professional | | $0.11 | $0.14 | $0.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.19 / $4.17
| Facility | | $0.11 | $0.19 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.12 / $309.03
| Professional | | $0.11 | $0.12 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.13 / $0.14 / $0.16
| Professional | | $0.13 | $0.14 | $0.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.28 / $2.40
| Professional | | $0.15 | $0.28 | $2.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $724.44 / $724.44
| Facility | | $616.60 | $724.44 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.15 / $0.32
| Facility | | $0.11 | $0.15 | $0.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.12 / $0.14
| Professional | | $0.11 | $0.12 | $0.14 |