- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $19.95 / $147.91
| Facility | | $1.70 | $19.95 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $1.26 / $1.74
| Professional | | $1.20 | $1.26 | $1.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.74 / $0.81 / $1.07
| Facility | | $0.74 | $0.81 | $1.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $0.71 / $1.51
| Professional | | $0.32 | $0.71 | $1.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.79 / $1.00
| Facility | | $0.71 | $0.79 | $1.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.89 / $2.69
| Professional | | $0.71 | $0.89 | $2.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $1.41 / $1.78
| Facility | | $0.71 | $1.41 | $1.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.71 / $0.71
| Professional | | $0.71 | $0.71 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $398.11 / $398.11
| Professional | | $398.11 | $398.11 | $398.11 |
- 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
- $0.09 / $0.09 / $0.09
| Professional | | $0.09 | $0.09 | $0.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $1.00 / $1.91
| Facility | | $0.52 | $1.00 | $1.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.71 / $0.71
| Professional | | $0.71 | $0.71 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.85 / $1.12 / $1.45
| Professional | | $0.85 | $1.12 | $1.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $10.72
| Facility | | $10.72 | $10.72 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.71 / $1.86
| Professional | | $0.71 | $0.71 | $1.86 |