- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $281.84 / $660.69
| Facility | | $75.86 | $281.84 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $199.53 / $891.25
| Professional | | $50.12 | $199.53 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.24 / $0.47 / $1.45
| Facility | | $0.24 | $0.47 | $1.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.26 / $0.44
| Professional | | $0.22 | $0.26 | $0.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.28 / $0.28
| Facility | | $0.28 | $0.28 | $0.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.23 / $0.23 / $0.23
| Facility | | $0.23 | $0.23 | $0.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.31 / $0.31 / $0.31
| Professional | | $0.31 | $0.31 | $0.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.42 / $0.47 / $0.74
| Facility | | $0.42 | $0.47 | $0.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.22 / $0.24
| Professional | | $0.22 | $0.22 | $0.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.40 / $1.12 / $2.24
| Facility | | $0.40 | $1.12 | $2.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.24 / $0.24 / $0.78
| Professional | | $0.24 | $0.24 | $0.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.23 / $0.28 / $0.33
| Professional | | $0.23 | $0.28 | $0.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.37 / $0.51
| Professional | | $0.21 | $0.37 | $0.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.52 / $0.52
| Facility | | $0.28 | $0.52 | $0.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.59 / $0.60 / $0.65
| Professional | | $0.59 | $0.60 | $0.65 |