- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.83 / $165.96 / $323.59
| Facility | | $0.83 | $165.96 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.07 / $120.23
| Professional | | $1.00 | $1.07 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $0.45 / $0.45
| Facility | | $0.45 | $0.45 | $0.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.36 / $0.45
| Professional | | $0.36 | $0.36 | $0.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.48 / $0.89 / $1.32
| Facility | | $0.48 | $0.89 | $1.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.47 / $0.68
| Professional | | $0.36 | $0.47 | $0.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.33 / $0.36 / $0.71
| Facility | | $0.33 | $0.36 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $0.72 / $0.72
| Professional | | $0.26 | $0.72 | $0.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.33 / $0.36 / $1.51
| Facility | | $0.33 | $0.36 | $1.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.36 / $0.58
| Professional | | $0.36 | $0.36 | $0.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $64.57 / $85.11
| Professional | | $0.36 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.38 / $0.38
| Facility | | $0.38 | $0.38 | $0.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.44 / $1.00
| Professional | | $0.36 | $0.44 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.36 / $100.00
| Facility | | $0.36 | $0.36 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.36 / $0.36
| Professional | | $0.36 | $0.36 | $0.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $0.49 / $0.60
| Professional | | $0.45 | $0.49 | $0.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.36 / $0.83
| Facility | | $0.36 | $0.36 | $0.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.36 / $0.49
| Professional | | $0.36 | $0.36 | $0.49 |