- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $7.76 / $91.20
| Facility | | $1.62 | $7.76 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.98 / $2.82 / $7.59
| Professional | | $0.98 | $2.82 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $38.02 / $51.29
| Professional | | $25.70 | $38.02 | $51.29 |
- 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
- $0.34 / $0.34 / $0.34
| Professional | | $0.34 | $0.34 | $0.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $0.45 / $1.55
| Facility | | $0.45 | $0.45 | $1.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.34 / $0.34 / $0.42
| Professional | | $0.34 | $0.34 | $0.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $64.57 / $75.86
| Professional | | $64.57 | $64.57 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.30 / $0.56 / $0.76
| Facility | | $0.30 | $0.56 | $0.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $1.66 / $1.66
| Facility | | $0.52 | $1.66 | $1.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.52 / $0.52
| Professional | | $0.38 | $0.52 | $0.52 |
- 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
- $0.34 / $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
- $0.33 / $0.33 / $0.50
| Professional | | $0.33 | $0.33 | $0.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.33 / $0.34 / $0.44
| Professional | | $0.33 | $0.34 | $0.44 |