- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $51.29 / $977.24
| Facility | | $1.32 | $51.29 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $1.41 / $2.69
| Professional | | $0.65 | $1.41 | $2.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $0.76 / $0.79
| Facility | | $0.60 | $0.76 | $0.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.72 / $0.76
| Professional | | $0.71 | $0.72 | $0.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.68 / $0.68
| Facility | | $0.68 | $0.68 | $0.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.71 / $0.83
| Professional | | $0.68 | $0.71 | $0.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $35.48 / $120.23
| Facility | | $2.19 | $35.48 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.71 / $0.71
| Professional | | $0.62 | $0.71 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.74 / $0.74 / $0.74
| Professional | | $0.74 | $0.74 | $0.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $724.44 / $724.44
| Facility | | $616.60 | $724.44 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.76 / $1.62
| Facility | | $0.62 | $0.76 | $1.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.66 / $0.66
| Professional | | $0.62 | $0.66 | $0.66 |