- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $1.51 / $2.00
| Facility | | $1.32 | $1.51 | $2.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.32 / $3.31
| Professional | | $1.00 | $1.32 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.78 / $0.78 / $0.78
| Facility | | $0.78 | $0.78 | $0.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.62 / $0.78
| Professional | | $0.62 | $0.62 | $0.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.74 / $1.02 / $2.34
| Facility | | $0.74 | $1.02 | $2.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.83 / $1.20
| Professional | | $0.62 | $0.83 | $1.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.62 / $1.00
| Facility | | $0.62 | $0.62 | $1.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.91 / $1.23 / $1.58
| Professional | | $0.91 | $1.23 | $1.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.62 / $6.92
| Facility | | $0.62 | $0.62 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.68 / $1.23
| Professional | | $0.62 | $0.68 | $1.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.66 / $64.57 / $85.11
| Professional | | $0.66 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.26 / $2.95
| Facility | | $1.26 | $1.26 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.89 / $2.19
| Professional | | $0.62 | $0.89 | $2.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.66 / $0.66 / $100.00
| Facility | | $0.66 | $0.66 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.66 / $0.66 / $0.66
| Professional | | $0.66 | $0.66 | $0.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.83 / $0.83 / $1.12
| Professional | | $0.83 | $0.83 | $1.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.59 / $0.59 / $1.38
| Facility | | $0.59 | $0.59 | $1.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.66 / $0.72 / $0.98
| Professional | | $0.66 | $0.72 | $0.98 |