- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $1.78 / $3.89
| Facility | | $1.45 | $1.78 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.58 / $5.75
| Professional | | $1.00 | $1.58 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $3.47 / $6.61
| Facility | | $1.45 | $3.47 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $1.45 / $1.45
| Professional | | $1.45 | $1.45 | $1.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $2.45 / $6.92
| Facility | | $1.02 | $2.45 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $1.02 / $1.02
| Professional | | $1.02 | $1.02 | $1.02 |
- 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
- $0.98 / $1.70 / $3.39
| Facility | | $0.98 | $1.70 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.58 / $4.47
| Professional | | $1.00 | $1.58 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $0.95 / $0.98
| Professional | | $0.95 | $0.95 | $0.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $478.63 / $478.63
| Facility | | $446.68 | $478.63 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.98 / $1.41 / $4.90
| Facility | | $0.98 | $1.41 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $1.02 / $1.02
| Professional | | $1.02 | $1.02 | $1.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.35 / $1.35
| Facility | | $1.00 | $1.35 | $1.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.81 / $0.98 / $0.98
| Professional | | $0.81 | $0.98 | $0.98 |