- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $30.20 / $128.82
| Facility | | $1.41 | $30.20 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.48 / $6.46
| Professional | | $1.00 | $1.48 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $1.29 / $1.29
| Professional | | $1.29 | $1.29 | $1.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.35 / $1.35
| Facility | | $1.35 | $1.35 | $1.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.35 / $1.35
| Professional | | $1.35 | $1.35 | $1.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $1.78 / $6.03
| Facility | | $1.78 | $1.78 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.35 / $1.66
| Professional | | $1.35 | $1.35 | $1.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $64.57 / $75.86
| Professional | | $64.57 | $64.57 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.26 / $2.24
| Facility | | $1.26 | $1.26 | $2.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $4.17 / $4.17
| Facility | | $2.09 | $4.17 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $2.09 / $2.09
| Professional | | $1.48 | $2.09 | $2.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.35 / $1.35
| Facility | | $1.35 | $1.35 | $1.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.35 / $1.35
| Professional | | $1.35 | $1.35 | $1.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $1.23 / $2.88
| Facility | | $1.23 | $1.23 | $2.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $1.29 / $1.29
| Professional | | $1.23 | $1.29 | $1.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $1.35 / $1.78
| Professional | | $1.29 | $1.35 | $1.78 |