- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $8.13 / $64.57
| Facility | | $2.19 | $8.13 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $7.41 / $39.81
| Professional | | $0.26 | $7.41 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.22 / $0.22
| Professional | | $0.22 | $0.22 | $0.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.24 / $0.28 / $0.33
| Facility | | $0.24 | $0.28 | $0.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.22 / $1.02
| Professional | | $0.22 | $0.22 | $1.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.68 / $1.07
| Facility | | $0.21 | $0.68 | $1.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.24 / $0.24 / $0.39
| Professional | | $0.24 | $0.24 | $0.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.21 / $0.22
| Facility | | $0.21 | $0.21 | $0.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.21 / $0.21
| Professional | | $0.21 | $0.21 | $0.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.20 / $0.28 / $0.95
| Facility | | $0.20 | $0.28 | $0.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.24 / $1.07 / $53,703.18
| Facility | | $0.24 | $1.07 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.24 / $0.24 / $0.47
| Facility | | $0.24 | $0.24 | $0.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $0.19 / $1.58
| Professional | | $0.18 | $0.19 | $1.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.21 / $0.24
| Facility | | $0.21 | $0.21 | $0.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.21 / $0.25
| Professional | | $0.21 | $0.21 | $0.25 |