- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $48.98 / $100.00
| Facility | | $1.48 | $48.98 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $2.34 / $6.46
| Professional | | $1.32 | $2.34 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.83 / $0.83 / $0.83
| Facility | | $0.83 | $0.83 | $0.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.68 / $0.85
| Professional | | $0.68 | $0.68 | $0.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.89 / $2.34 / $4.07
| Facility | | $0.89 | $2.34 | $4.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $0.79 / $1.17
| Professional | | $0.65 | $0.79 | $1.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.13 / $1.00 / $1.66
| Facility | | $0.13 | $1.00 | $1.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $2.04 / $2.04
| Professional | | $0.26 | $2.04 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $6.17 / $69.18
| Facility | | $0.95 | $6.17 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $0.95 / $2.04
| Professional | | $0.95 | $0.95 | $2.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $64.57 / $85.11
| Professional | | $0.65 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $1.51 / $1.51
| Facility | | $1.51 | $1.51 | $1.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $1.05 / $3.89
| Professional | | $0.68 | $1.05 | $3.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $0.65 / $100.00
| Facility | | $0.65 | $0.65 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $0.65 / $0.65
| Professional | | $0.65 | $0.65 | $0.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.89 / $0.89 / $2.19
| Professional | | $0.89 | $0.89 | $2.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.68 / $1.58
| Facility | | $0.68 | $0.68 | $1.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $0.65 / $0.89
| Professional | | $0.65 | $0.65 | $0.89 |