- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $125.89 / $398.11
| Facility | | $9.33 | $125.89 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.45 / $120.23
| Professional | | $1.00 | $1.45 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.37 / $0.93 / $1.70
| Facility | | $0.37 | $0.93 | $1.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.38 / $0.74
| Professional | | $0.38 | $0.38 | $0.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.33 / $2.04 / $309.03
| Facility | | $0.33 | $2.04 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $630.96 / $630.96
| Facility | | $630.96 | $630.96 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.87 / $2.45
| Facility | | $0.38 | $0.87 | $2.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.36 / $0.36
| Professional | | $0.36 | $0.36 | $0.36 |
- 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
- $0.36 / $61.66 / $380.19
| Facility | | $0.36 | $61.66 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $1.00 / $1.58
| Professional | | $0.32 | $1.00 | $1.58 |
- 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 / $0.51 / $1.12
| Facility | | $0.36 | $0.51 | $1.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.36 / $0.36
| Professional | | $0.36 | $0.36 | $0.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.44 / $0.59 / $0.59
| Facility | | $0.44 | $0.59 | $0.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.36 / $0.36
| Professional | | $0.36 | $0.36 | $0.36 |