- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $8.91 / $18.20
| Facility | | $2.63 | $8.91 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.17 / $1.10
| Professional | | $0.05 | $0.17 | $1.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.07 / $0.13
| Facility | | $0.05 | $0.07 | $0.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.08 / $0.08 / $0.45
| Professional | | $0.08 | $0.08 | $0.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.08 / $0.09 / $0.22
| Facility | | $0.08 | $0.09 | $0.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.08 / $0.08 / $0.54
| Professional | | $0.08 | $0.08 | $0.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.07 / $0.08 / $8.91
| Facility | | $0.07 | $0.08 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.13 / $1.05
| Professional | | $0.05 | $0.13 | $1.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.05 / $0.05
| Professional | | $0.05 | $0.05 | $0.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.09 / $0.09
| Facility | | $0.09 | $0.09 | $0.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.08 / $0.09 / $0.09
| Professional | | $0.08 | $0.09 | $0.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.08 / $0.08 / $0.08
| Professional | | $0.08 | $0.08 | $0.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.03 / $0.03 / $0.04
| Facility | | $0.03 | $0.03 | $0.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.03 / $0.07 / $0.08
| Professional | | $0.03 | $0.07 | $0.08 |