- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $67.61 / $954.99
| Facility | | $7.76 | $67.61 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $5.50 / $6.03
| Professional | | $1.07 | $5.50 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $5.62 / $10.96
| Facility | | $2.19 | $5.62 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $2.82 / $2.82
| Professional | | $2.82 | $2.82 | $2.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $6.46 / $13.18
| Facility | | $0.68 | $6.46 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $26.30 / $26.30
| Facility | | $26.30 | $26.30 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.42 / $0.93 / $2.51
| Facility | | $0.42 | $0.93 | $2.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.37 / $0.37 / $0.37
| Professional | | $0.37 | $0.37 | $0.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $63.10 / $758.58
| Facility | | $3.63 | $63.10 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $1.51 / $7.41
| Professional | | $0.32 | $1.51 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.39 / $0.39 / $0.43
| Professional | | $0.39 | $0.39 | $0.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.56 / $3.16
| Facility | | $0.38 | $0.56 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.37 / $0.37 / $0.37
| Professional | | $0.37 | $0.37 | $0.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.71 / $0.71
| Facility | | $0.52 | $0.71 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.38 / $0.43
| Professional | | $0.38 | $0.38 | $0.43 |