- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $6.46 / $95.50
| Facility | | $1.20 | $6.46 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $1.78 / $2.14
| Professional | | $1.20 | $1.78 | $2.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.85 / $0.85 / $1.00
| Facility | | $0.85 | $0.85 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.72 / $0.85 / $5,011.87
| Facility | | $0.72 | $0.85 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.81 / $0.81 / $0.81
| Professional | | $0.81 | $0.81 | $0.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $2.40 / $2.51
| Facility | | $0.68 | $2.40 | $2.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.68 / $0.68
| Professional | | $0.68 | $0.68 | $0.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.68 / $0.68
| Facility | | $0.68 | $0.68 | $0.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $1.17 / $1.17
| Professional | | $1.02 | $1.17 | $1.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $4.17 / $10.96
| Facility | | $2.24 | $4.17 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.85 / $0.85 / $1.00
| Facility | | $0.85 | $0.85 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $1.23 / $2.04
| Facility | | $1.02 | $1.23 | $2.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $1.05 / $1.05
| Professional | | $1.05 | $1.05 | $1.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.91 / $1.58
| Facility | | $0.68 | $0.91 | $1.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.91 / $1.58
| Professional | | $0.68 | $0.91 | $1.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.74 / $0.78 / $1.07
| Professional | | $0.74 | $0.78 | $1.07 |