- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.82 / $8.32
| Facility | | $2.09 | $2.82 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $3.89
| Professional | | $1.00 | $1.00 | $3.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $1.45 / $2.04
| Facility | | $1.29 | $1.45 | $2.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.41 / $7.76
| Professional | | $1.35 | $1.41 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.04 / $2.88
| Facility | | $2.04 | $2.04 | $2.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.74 / $4.47
| Professional | | $1.35 | $1.74 | $4.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $2.04 / $2.75
| Facility | | $1.23 | $2.04 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $1.17 / $1.23
| Professional | | $1.17 | $1.17 | $1.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.48 / $5.01
| Professional | | $1.07 | $1.48 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $104.71 / $104.71
| Facility | | $100.00 | $104.71 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $1.32 / $1.32
| Professional | | $1.32 | $1.32 | $1.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $2.19 / $3.89
| Facility | | $1.23 | $2.19 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $1.17 / $2.51
| Professional | | $1.17 | $1.17 | $2.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $2.69
| Professional | | $2.69 | $2.69 | $2.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $5.62
| Facility | | $5.62 | $5.62 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.35 / $3.72
| Professional | | $1.35 | $1.35 | $3.72 |