- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $41.69 / $338.84
| Facility | | $1.35 | $41.69 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.29 / $7.76
| Professional | | $1.26 | $1.29 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $3.55 / $6.61
| Facility | | $1.48 | $3.55 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.07 / $1.07
| Professional | | $1.07 | $1.07 | $1.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $8.13 / $89.13
| Facility | | $1.00 | $8.13 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.78 / $1.66 / $4.57
| Facility | | $0.78 | $1.66 | $4.57 |
- 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
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.79 / $1.91 / $323.59
| Facility | | $0.79 | $1.91 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.29 / $3.89
| Professional | | $1.00 | $1.29 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.78 / $0.78 / $0.79
| Professional | | $0.78 | $0.78 | $0.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $1.12 / $2.14
| Facility | | $0.71 | $1.12 | $2.14 |
- 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
- $0.95 / $1.29 / $1.29
| Facility | | $0.95 | $1.29 | $1.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.78 / $0.78 / $0.78
| Professional | | $0.78 | $0.78 | $0.78 |