- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $60.26 / $123.03
| Facility | | $3.39 | $60.26 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $0.87 / $7.94
| Professional | | $0.45 | $0.87 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.21 / $0.21
| Facility | | $0.21 | $0.21 | $0.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $0.17 / $0.21
| Professional | | $0.17 | $0.17 | $0.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.27 / $0.48
| Facility | | $0.15 | $0.27 | $0.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.19 / $0.26
| Professional | | $0.15 | $0.19 | $0.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.15 / $0.71
| Facility | | $0.15 | $0.15 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.23 / $0.30 / $0.30
| Professional | | $0.23 | $0.30 | $0.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $16.22 / $38.02
| Facility | | $1.17 | $16.22 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.16 / $0.30
| Professional | | $0.16 | $0.16 | $0.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $64.57 / $85.11
| Professional | | $64.57 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.15 / $0.37
| Facility | | $0.15 | $0.15 | $0.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $0.25 / $1.00
| Professional | | $0.17 | $0.25 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.14 / $0.14 / $100.00
| Facility | | $0.14 | $0.14 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.14 / $0.14 / $0.14
| Professional | | $0.14 | $0.14 | $0.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.23 / $0.28
| Professional | | $0.16 | $0.23 | $0.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.13 / $0.13 / $0.30
| Facility | | $0.13 | $0.13 | $0.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.14 / $0.14 / $0.21
| Professional | | $0.14 | $0.14 | $0.21 |