- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $8.32 / $89.13
| Facility | | $1.51 | $8.32 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $0.79 / $1.45
| Professional | | $0.18 | $0.79 | $1.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.59 / $1.41 / $2.69
| Facility | | $0.59 | $1.41 | $2.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.14 / $0.14 / $0.14
| Professional | | $0.14 | $0.14 | $0.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.20 / $7.76 / $34.67
| Facility | | $0.20 | $7.76 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.14 / $2.09
| Professional | | $0.09 | $0.14 | $2.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $1.91 / $1.91
| Facility | | $1.91 | $1.91 | $1.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.23 / $1.38 / $4.79
| Facility | | $0.23 | $1.38 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.79 / $0.79 / $0.79
| Professional | | $0.79 | $0.79 | $0.79 |
- 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
- $1.51 / $9.33 / $91.20
| Facility | | $1.51 | $9.33 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.12 / $0.79 / $7.76
| Professional | | $0.12 | $0.79 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.10 / $0.10 / $0.10
| Professional | | $0.10 | $0.10 | $0.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.79 / $2.51
| Facility | | $0.09 | $0.79 | $2.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $0.79 / $0.79
| Professional | | $0.32 | $0.79 | $0.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.15 / $0.15
| Facility | | $0.11 | $0.15 | $0.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.50 / $1.45
| Professional | | $0.09 | $0.50 | $1.45 |