- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $57.54 / $724.44
| Facility | | $7.59 | $57.54 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.63 / $4.37 / $120.23
| Professional | | $0.63 | $4.37 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.71 / $1.17
| Professional | | $0.71 | $0.71 | $1.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.98 / $1.12 / $1.66
| Professional | | $0.98 | $1.12 | $1.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.98 / $1.32 / $1.78
| Facility | | $0.98 | $1.32 | $1.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.71 / $0.71
| Professional | | $0.71 | $0.71 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $0.66 / $7.41
| Professional | | $0.60 | $0.66 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.24 / $3.24
| Professional | | $3.24 | $3.24 | $3.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.66 / $1.62 / $4.47
| Facility | | $0.66 | $1.62 | $4.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.85 / $4.90
| Facility | | $0.68 | $0.85 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.85 / $4.90
| Professional | | $0.68 | $0.85 | $4.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $1.02 / $1.32
| Facility | | $1.02 | $1.02 | $1.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.66 / $0.69
| Professional | | $0.62 | $0.66 | $0.69 |