- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $34.67 / $158.49
| Facility | | $3.80 | $34.67 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $2.95 / $5.25
| Professional | | $1.35 | $2.95 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.15 / $0.28
| Facility | | $0.05 | $0.15 | $0.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.09 / $0.23
| Professional | | $0.09 | $0.09 | $0.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $0.34 / $0.49
| Facility | | $0.25 | $0.34 | $0.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $1.55 / $1.55
| Facility | | $1.55 | $1.55 | $1.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.33 / $0.87
| Facility | | $0.15 | $0.33 | $0.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.13 / $0.13 / $0.13
| Professional | | $0.13 | $0.13 | $0.13 |
- 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
- $3.31 / $32.36 / $165.96
| Facility | | $3.31 | $32.36 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $2.45 / $5.25
| Professional | | $0.32 | $2.45 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.12 / $0.12 / $0.13
| Professional | | $0.12 | $0.12 | $0.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.12 / $0.17 / $0.49
| Facility | | $0.12 | $0.17 | $0.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.13 / $0.13 / $0.13
| Professional | | $0.13 | $0.13 | $0.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $0.35 / $0.35
| Facility | | $0.26 | $0.35 | $0.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.12 / $0.12 / $0.21
| Professional | | $0.12 | $0.12 | $0.21 |