- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $58.88 / $257.04
| Facility | | $8.51 | $58.88 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $13.80 / $60.26
| Professional | | $0.45 | $13.80 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.28 / $0.28
| Facility | | $0.28 | $0.28 | $0.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.22 / $0.27
| Professional | | $0.22 | $0.22 | $0.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.54 / $0.79
| Facility | | $0.28 | $0.54 | $0.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.19 / $0.23 / $0.33
| Professional | | $0.19 | $0.23 | $0.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.20 / $0.21 / $0.33
| Facility | | $0.20 | $0.21 | $0.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $0.42 / $0.42
| Professional | | $0.26 | $0.42 | $0.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.34 / $3.89 / $7.24
| Facility | | $0.34 | $3.89 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.22 / $0.42
| Professional | | $0.22 | $0.22 | $0.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $64.57 / $85.11
| Professional | | $0.18 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.28 / $0.28
| Facility | | $0.28 | $0.28 | $0.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.35 / $1.00
| Professional | | $0.22 | $0.35 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $0.18 / $186.21
| Facility | | $0.18 | $0.18 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $0.18 / $0.18
| Professional | | $0.18 | $0.18 | $0.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $0.30 / $0.37
| Professional | | $0.25 | $0.30 | $0.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.22 / $0.51
| Facility | | $0.22 | $0.22 | $0.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $0.18 / $0.27
| Professional | | $0.18 | $0.18 | $0.27 |