- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $39.81 / $93.33
| Facility | | $2.88 | $39.81 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.12 / $4.27
| Professional | | $1.00 | $1.12 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $1.20 / $1.20
| Facility | | $1.20 | $1.20 | $1.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $0.95 / $1.20
| Professional | | $0.95 | $0.95 | $1.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $2.45 / $3.63
| Facility | | $1.26 | $2.45 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $1.35 / $2.00
| Professional | | $0.95 | $1.35 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.10 / $2.14
| Facility | | $1.10 | $1.10 | $2.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $2.14 / $2.14
| Professional | | $0.26 | $2.14 | $2.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $34.67 / $52.48
| Facility | | $2.19 | $34.67 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.12 / $2.14
| Professional | | $1.00 | $1.12 | $2.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $64.57 / $85.11
| Professional | | $64.57 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.91 / $1.15 / $1.15
| Facility | | $0.91 | $1.15 | $1.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $1.86 / $3.31
| Professional | | $0.95 | $1.86 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.07 / $100.00
| Facility | | $1.07 | $1.07 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.07 / $1.07
| Professional | | $1.07 | $1.07 | $1.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $1.29 / $2.40
| Professional | | $1.29 | $1.29 | $2.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $2.63
| Facility | | $1.12 | $1.12 | $2.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.20 / $1.58
| Professional | | $1.07 | $1.20 | $1.58 |