- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.29 / $3.24
| Facility | | $1.07 | $1.29 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $0.60 / $1.32
| Professional | | $0.25 | $0.60 | $1.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $47.86
| Professional | | $40.74 | $40.74 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.58 / $0.78
| Facility | | $0.52 | $0.58 | $0.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $0.51 / $0.98
| Professional | | $0.50 | $0.51 | $0.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $102.33 / $102.33
| Professional | | $102.33 | $102.33 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.51 / $0.95 / $1.29
| Facility | | $0.51 | $0.95 | $1.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.51 / $0.51 / $0.51
| Professional | | $0.51 | $0.51 | $0.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.00 / $630.96
| Professional | | $1.00 | $2.00 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.51 / $0.51 / $1.00
| Facility | | $0.51 | $0.51 | $1.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.51 / $0.51 / $0.51
| Professional | | $0.51 | $0.51 | $0.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.08 / $0.45 / $0.76
| Facility | | $0.08 | $0.45 | $0.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.30 / $0.50 / $0.76
| Professional | | $0.30 | $0.50 | $0.76 |