- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $48.98 / $363.08
| Facility | | $2.19 | $48.98 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $2.95
| Professional | | $1.00 | $1.00 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.26 / $1.66
| Facility | | $1.12 | $1.26 | $1.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.12 / $5.37
| Professional | | $1.10 | $1.12 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $1.74 / $2.40
| Facility | | $1.74 | $1.74 | $2.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.45 / $3.63
| Professional | | $1.10 | $1.45 | $3.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.86 / $2.51
| Facility | | $1.12 | $1.86 | $2.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.10 / $1.12
| Professional | | $1.10 | $1.10 | $1.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.98 / $1.20 / $7.08
| Professional | | $0.98 | $1.20 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $1.12
| Professional | | $1.12 | $1.12 | $1.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $2.00 / $3.80
| Facility | | $1.10 | $2.00 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.10 / $2.34
| Professional | | $1.10 | $1.10 | $2.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $2.95 / $2.95
| Professional | | $2.95 | $2.95 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $6.17
| Facility | | $6.17 | $6.17 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.10 / $4.07
| Professional | | $1.10 | $1.10 | $4.07 |