- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $38.90 / $147.91
| Facility | | $6.03 | $38.90 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $8.32 / $12.59
| Professional | | $1.38 | $8.32 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.58 / $2.51 / $5.25
| Facility | | $0.58 | $2.51 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.74 / $0.74 / $0.74
| Professional | | $0.74 | $0.74 | $0.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $6.76 / $22.91
| Facility | | $1.32 | $6.76 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $16.22
| Facility | | $16.22 | $16.22 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $1.32 / $3.63
| Facility | | $0.62 | $1.32 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.54 / $0.54 / $0.54
| Professional | | $0.54 | $0.54 | $0.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $239.88 / $239.88
| Facility | | $239.88 | $239.88 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $41.69 / $208.93
| Facility | | $5.62 | $41.69 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.63 / $1.58 / $16.98
| Professional | | $0.63 | $1.58 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.54 / $0.54 / $0.59
| Professional | | $0.54 | $0.54 | $0.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.54 / $0.79 / $4.57
| Facility | | $0.54 | $0.79 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.54 / $0.54 / $0.54
| Professional | | $0.54 | $0.54 | $0.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.63 / $0.85 / $0.85
| Facility | | $0.63 | $0.85 | $0.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.52 / $0.52
| Professional | | $0.52 | $0.52 | $0.52 |