- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $17.38 / $61.66
| Facility | | $1.58 | $17.38 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.42 / $1.45
| Professional | | $0.21 | $0.42 | $1.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $23.99
| Professional | | $14.13 | $14.13 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $0.28 / $0.40
| Facility | | $0.26 | $0.28 | $0.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.24 / $0.26 / $0.44
| Professional | | $0.24 | $0.26 | $0.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.36 / $0.46
| Facility | | $0.36 | $0.36 | $0.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $0.28 / $0.51
| Professional | | $0.26 | $0.28 | $0.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.24 / $0.36 / $0.54
| Facility | | $0.24 | $0.36 | $0.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.24 / $0.24 / $0.36
| Professional | | $0.24 | $0.24 | $0.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.14 / $0.17 / $0.20
| Professional | | $0.14 | $0.17 | $0.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.26 / $0.59
| Professional | | $0.21 | $0.26 | $0.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.16 / $0.16
| Professional | | $0.16 | $0.16 | $0.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $0.28 / $0.52
| Facility | | $0.25 | $0.28 | $0.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.24 / $0.24 / $0.36
| Professional | | $0.24 | $0.24 | $0.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.59 / $0.59 / $0.59
| Professional | | $0.59 | $0.59 | $0.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.19 / $0.26 / $0.40
| Professional | | $0.19 | $0.26 | $0.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.87 / $0.87
| Facility | | $0.02 | $0.87 | $0.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $0.26 / $0.62
| Professional | | $0.17 | $0.26 | $0.62 |