- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $158.49 / $691.83
| Facility | | $2.40 | $158.49 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.07 / $204.17
| Professional | | $1.00 | $1.07 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.41 / $0.55
| Facility | | $0.38 | $0.41 | $0.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.37 / $1.05
| Professional | | $0.36 | $0.37 | $1.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.43 / $0.54
| Facility | | $0.38 | $0.43 | $0.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.47 / $1.07
| Professional | | $0.36 | $0.47 | $1.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.37 / $0.62 / $0.83
| Facility | | $0.37 | $0.62 | $0.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.36 / $0.38
| Professional | | $0.36 | $0.36 | $0.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.33 / $0.40 / $1.00
| Professional | | $0.33 | $0.40 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.37 / $0.37 / $0.37
| Professional | | $0.37 | $0.37 | $0.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.60 / $0.95
| Facility | | $0.36 | $0.60 | $0.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.36 / $0.72
| Professional | | $0.36 | $0.36 | $0.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.63 / $0.63 / $0.63
| Professional | | $0.63 | $0.63 | $0.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $1.23 / $1.23
| Facility | | $1.23 | $1.23 | $1.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.36 / $0.89
| Professional | | $0.36 | $0.36 | $0.89 |