- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $25.70 / $89.13
| Facility | | $7.76 | $25.70 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $3.89 / $162.18
| Professional | | $2.29 | $3.89 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.85 / $20.89
| Professional | | $15.14 | $15.85 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $1.45 / $3.02
| Facility | | $0.56 | $1.45 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.35 / $0.35
| Professional | | $0.35 | $0.35 | $0.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $0.34 / $10.72
| Professional | | $0.18 | $0.34 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $4.68
| Facility | | $4.68 | $4.68 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.19 / $0.40 / $1.07
| Facility | | $0.19 | $0.40 | $1.07 |
- 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
- $363.08 / $363.08 / $363.08
| Facility | | $363.08 | $363.08 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $154.88 / $154.88
| Professional | | $154.88 | $154.88 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.26 / $9.12
| Facility | | $0.15 | $0.26 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.20 / $3.63 / $162.18
| Professional | | $0.20 | $3.63 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.19 / $0.23
| Professional | | $0.15 | $0.19 | $0.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $1.10 / $30.20
| Professional | | $0.26 | $1.10 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.25 / $8.32
| Facility | | $0.15 | $0.25 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.16 / $0.27
| Professional | | $0.16 | $0.16 | $0.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $0.43 / $0.43
| Facility | | $0.32 | $0.43 | $0.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.16 / $4.07
| Professional | | $0.15 | $0.16 | $4.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.14 / $0.15 / $0.17
| Professional | | $0.14 | $0.15 | $0.17 |