- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $70.79 / $125.89
| Facility | | $8.71 | $70.79 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $6.76 / $29.51
| Professional | | $1.58 | $6.76 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $1.12
| Facility | | $1.12 | $1.12 | $1.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.89 / $0.89 / $1.12
| Professional | | $0.89 | $0.89 | $1.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $2.24 / $3.31
| Facility | | $1.17 | $2.24 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.76 / $0.93 / $1.38
| Professional | | $0.76 | $0.93 | $1.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.83 / $0.83 / $1.66
| Facility | | $0.83 | $0.83 | $1.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.70 / $1.70
| Professional | | $1.07 | $1.70 | $1.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $9.33 / $18.20
| Facility | | $1.55 | $9.33 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.85 / $0.85 / $1.70
| Professional | | $0.85 | $0.85 | $1.70 |
- 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
- $1.00 / $1.00 / $1.00
| Facility | | $1.00 | $1.00 | $1.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.89 / $1.32 / $3.47
| Professional | | $0.89 | $1.32 | $3.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.74 / $0.74 / $100.00
| Facility | | $0.74 | $0.74 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.74 / $0.74 / $0.74
| Professional | | $0.74 | $0.74 | $0.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $1.23 / $2.14
| Professional | | $1.23 | $1.23 | $2.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.87 / $0.87 / $2.04
| Facility | | $0.87 | $0.87 | $2.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.74 / $0.74 / $1.12
| Professional | | $0.74 | $0.74 | $1.12 |