- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $5.25 / $69.18
| Facility | | $1.45 | $5.25 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $2.19 / $5.37
| Professional | | $0.71 | $2.19 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $28.18 / $66.07
| Professional | | $28.18 | $28.18 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.36 / $199.53
| Facility | | $0.36 | $0.36 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.31 / $0.36 / $5,011.87
| Facility | | $0.31 | $0.36 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.35 / $0.35
| Professional | | $0.35 | $0.35 | $0.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.34 / $1.20 / $1.29
| Facility | | $0.34 | $1.20 | $1.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.34 / $0.34 / $0.34
| Professional | | $0.34 | $0.34 | $0.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.34 / $0.34 / $0.34
| Facility | | $0.34 | $0.34 | $0.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.51 / $0.59 / $0.59
| Professional | | $0.51 | $0.59 | $0.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $1.07 / $14.13
| Facility | | $0.35 | $1.07 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.36 / $199.53
| Facility | | $0.36 | $0.36 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.79 / $1.74 / $40.74
| Facility | | $0.79 | $1.74 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.15 / $141.25
| Professional | | $1.00 | $1.15 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.59 / $2.04
| Facility | | $0.35 | $0.59 | $2.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.59 / $2.04
| Professional | | $0.35 | $0.59 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.34 / $0.34 / $0.34
| Facility | | $0.34 | $0.34 | $0.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.33 / $0.33 / $0.60
| Professional | | $0.33 | $0.33 | $0.60 |