- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $12.59 / $85.11
| Facility | | $1.26 | $12.59 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $6.46 / $6.46
| Professional | | $1.32 | $6.46 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.72 / $0.72 / $0.85
| Facility | | $0.72 | $0.72 | $0.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.72 / $0.72 / $0.83
| Professional | | $0.72 | $0.72 | $0.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.98 / $0.98 / $3.39
| Facility | | $0.98 | $0.98 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.72 / $0.72 / $0.89
| Professional | | $0.72 | $0.72 | $0.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.09 / $75.86
| Professional | | $2.82 | $3.09 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.81 / $1.48
| Facility | | $0.71 | $0.81 | $1.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $2.51 / $9.12
| Facility | | $1.20 | $2.51 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.91 / $1.20 / $1.55
| Professional | | $0.91 | $1.20 | $1.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.72 / $0.72 / $0.85
| Facility | | $0.72 | $0.72 | $0.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.72 / $0.72 / $0.83
| Professional | | $0.72 | $0.72 | $0.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.28 / $0.69
| Facility | | $0.28 | $0.28 | $0.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.69 / $0.72 / $0.72
| Professional | | $0.69 | $0.72 | $0.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.72 / $0.72 / $0.95
| Professional | | $0.72 | $0.72 | $0.95 |