- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $30.20 / $234.42
| Facility | | $4.27 | $30.20 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $0.46 / $16.98
| Professional | | $0.26 | $0.46 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.14 / $0.35 / $0.71
| Facility | | $0.14 | $0.35 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.02 / $0.42
| Professional | | $0.02 | $0.02 | $0.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.78 / $38.90
| Facility | | $0.21 | $0.78 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $27.54 / $27.54
| Facility | | $27.54 | $27.54 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.52 / $1.48
| Facility | | $0.22 | $0.52 | $1.48 |
- 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
- $186.21 / $186.21 / $186.21
| Facility | | $186.21 | $186.21 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $36.31 / $251.19
| Facility | | $4.07 | $36.31 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.45 / $16.98
| Professional | | $0.22 | $0.45 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $0.18 / $0.21
| Professional | | $0.18 | $0.18 | $0.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $0.26 / $0.71
| Facility | | $0.18 | $0.26 | $0.71 |
- 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
- $0.27 / $0.36 / $0.36
| Facility | | $0.27 | $0.36 | $0.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $0.18 / $0.22
| Professional | | $0.18 | $0.18 | $0.22 |