- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $10.23 / $524.81
| Facility | | $1.02 | $10.23 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.45 / $1.51
| Professional | | $1.07 | $1.45 | $1.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $3.63 / $6.92
| Facility | | $1.55 | $3.63 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $1.55 / $1.55
| Professional | | $1.55 | $1.55 | $1.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.38 / $0.38
| Facility | | $0.38 | $0.38 | $0.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $0.78 / $2.14
| Facility | | $0.32 | $0.78 | $2.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $0.32 / $2.19
| Professional | | $0.32 | $0.32 | $2.19 |
- 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
- $0.32 / $0.40 / $1.51
| Facility | | $0.32 | $0.40 | $1.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $0.40 / $1.51
| Professional | | $0.32 | $0.40 | $1.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.32 / $0.39
| Professional | | $0.28 | $0.32 | $0.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $0.40 / $1.48
| Facility | | $0.32 | $0.40 | $1.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $0.32 / $2.19
| Professional | | $0.32 | $0.32 | $2.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.34 / $1.17
| Facility | | $0.11 | $0.34 | $1.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.38 / $0.38
| Professional | | $0.15 | $0.38 | $0.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.38 / $0.38
| Professional | | $0.38 | $0.38 | $0.38 |