- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $2.34 / $9.33
| Facility | | $0.56 | $2.34 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $0.55 / $14.13
| Professional | | $0.17 | $0.55 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $0.17 / $0.17
| Professional | | $0.17 | $0.17 | $0.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.13 / $0.22 / $0.26
| Facility | | $0.13 | $0.22 | $0.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $0.17 / $0.63
| Professional | | $0.17 | $0.17 | $0.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.21 / $0.58
| Facility | | $0.16 | $0.21 | $0.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $0.18 / $0.28
| Professional | | $0.18 | $0.18 | $0.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.15 / $0.16
| Facility | | $0.15 | $0.15 | $0.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.15 / $0.16
| Professional | | $0.15 | $0.15 | $0.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $0.36 / $0.87
| Facility | | $0.18 | $0.36 | $0.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $0.72 / $53,703.18
| Facility | | $0.18 | $0.72 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.14 / $0.14 / $0.28
| Facility | | $0.14 | $0.14 | $0.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.13 / $0.14 / $0.52
| Professional | | $0.13 | $0.14 | $0.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.15 / $0.18
| Facility | | $0.15 | $0.15 | $0.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.13 / $0.15 / $0.18
| Professional | | $0.13 | $0.15 | $0.18 |