- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $15.85 / $95.50
| Facility | | $4.37 | $15.85 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $2.09
| Professional | | $1.00 | $1.00 | $2.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $1.15 / $1.95
| Professional | | $1.15 | $1.15 | $1.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $1.51 / $2.29
| Professional | | $1.32 | $1.51 | $2.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $2.19 / $2.88
| Facility | | $1.62 | $2.19 | $2.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $1.15 / $1.15
| Professional | | $1.15 | $1.15 | $1.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.20 / $2.45
| Professional | | $1.00 | $1.20 | $2.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $1.20 / $1.20
| Professional | | $1.20 | $1.20 | $1.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $1.20 / $1.58
| Facility | | $0.41 | $1.20 | $1.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.41 / $3.72
| Facility | | $1.10 | $1.41 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.41 / $3.72
| Professional | | $1.10 | $1.41 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $1.82
| Facility | | $1.38 | $1.38 | $1.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.83 / $1.20 / $1.48
| Professional | | $0.83 | $1.20 | $1.48 |