- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $10.00 / $75.86
| Facility | | $3.89 | $10.00 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $1.38 / $1.91
| Professional | | $1.05 | $1.38 | $1.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.58 / $1.15 / $3.55
| Facility | | $0.58 | $1.15 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.54 / $0.62 / $1.02
| Professional | | $0.54 | $0.62 | $1.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.72 / $0.72 / $0.72
| Facility | | $0.72 | $0.72 | $0.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.59 / $0.59 / $0.59
| Facility | | $0.59 | $0.59 | $0.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.79 / $0.79 / $0.79
| Professional | | $0.79 | $0.79 | $0.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $1.15 / $1.78
| Facility | | $1.02 | $1.15 | $1.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.54 / $0.54 / $0.85
| Professional | | $0.54 | $0.54 | $0.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.59 / $2.45 / $9.33
| Facility | | $0.59 | $2.45 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.52 / $2.69
| Professional | | $0.52 | $0.52 | $2.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.66 / $0.81
| Professional | | $0.52 | $0.66 | $0.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $0.91 / $1.26
| Professional | | $0.50 | $0.91 | $1.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.63 / $1.12 / $1.12
| Facility | | $0.63 | $1.12 | $1.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.52 / $0.69
| Professional | | $0.52 | $0.52 | $0.69 |