- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $158.49 / $457.09
| Facility | | $1.00 | $158.49 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $2.00 / $2.00
| Professional | | $1.38 | $2.00 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $1.00 / $1.86
| Facility | | $0.41 | $1.00 | $1.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $0.52 / $0.87
| Professional | | $0.50 | $0.52 | $0.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.33 / $1.12 / $120.23
| Facility | | $0.33 | $1.12 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $954.99 / $954.99
| Facility | | $954.99 | $954.99 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $1.17 / $3.39
| Facility | | $0.50 | $1.17 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $0.50 / $0.50
| Professional | | $0.50 | $0.50 | $0.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.49 / $1.00 / $398.11
| Facility | | $0.49 | $1.00 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $1.00 / $2.00
| Professional | | $0.32 | $1.00 | $2.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $0.50 / $0.50
| Professional | | $0.50 | $0.50 | $0.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.56 / $1.58
| Facility | | $0.43 | $0.56 | $1.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $0.50 / $0.50
| Professional | | $0.50 | $0.50 | $0.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.83 / $0.83
| Facility | | $0.62 | $0.83 | $0.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $0.50 / $0.50
| Professional | | $0.50 | $0.50 | $0.50 |