- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $1.66 / $3.31
| Facility | | $1.15 | $1.66 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1.91
| Professional | | $1.00 | $1.00 | $1.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $1.74 / $3.09
| Facility | | $1.74 | $1.74 | $3.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $1.78
| Professional | | $1.38 | $1.38 | $1.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $2.88 / $4.27
| Facility | | $1.58 | $2.88 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.41 / $2.04
| Professional | | $1.12 | $1.41 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $1.10 / $1.10
| Facility | | $0.60 | $1.10 | $1.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.54 / $2.14 / $2.14
| Professional | | $0.54 | $2.14 | $2.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $1.12 / $1.12
| Facility | | $0.60 | $1.12 | $1.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $1.82
| Professional | | $1.12 | $1.12 | $1.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $64.57 / $85.11
| Professional | | $64.57 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.10 / $1.17
| Facility | | $1.10 | $1.10 | $1.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $3.24
| Professional | | $1.38 | $1.38 | $3.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $100.00
| Facility | | $1.12 | $1.12 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $1.12
| Professional | | $1.12 | $1.12 | $1.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.86 / $2.29
| Professional | | $1.35 | $1.86 | $2.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $2.63
| Facility | | $1.12 | $1.12 | $2.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $1.55
| Professional | | $1.12 | $1.12 | $1.55 |