- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $10.00 / $100.00
| Facility | | $2.57 | $10.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.78 / $3.16
| Professional | | $1.00 | $1.78 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.79 / $0.79 / $1.32
| Professional | | $0.79 | $0.79 | $1.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $1.29 / $1.95
| Professional | | $1.15 | $1.29 | $1.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.48 / $2.00
| Facility | | $1.10 | $1.48 | $2.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.79 / $0.79 / $0.79
| Professional | | $0.79 | $0.79 | $0.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.72 / $4.37
| Professional | | $0.68 | $0.72 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $8.91
| Professional | | $8.91 | $8.91 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.72 / $3.16 / $7.76
| Facility | | $0.72 | $3.16 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.76 / $0.95 / $3.39
| Facility | | $0.76 | $0.95 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.76 / $0.95 / $3.39
| Professional | | $0.76 | $0.95 | $3.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $1.29 / $1.70
| Facility | | $1.29 | $1.29 | $1.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.72 / $0.81 / $1.00
| Professional | | $0.72 | $0.81 | $1.00 |