- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.89 / $10.00 / $29.51
| Facility | | $0.89 | $10.00 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.42 / $1.26
| Professional | | $0.16 | $0.42 | $1.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $30.90 / $38.02
| Professional | | $16.98 | $30.90 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.21 / $0.25
| Facility | | $0.21 | $0.21 | $0.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.21 / $0.24
| Professional | | $0.21 | $0.21 | $0.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.28 / $0.93
| Facility | | $0.28 | $0.28 | $0.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.21 / $0.27
| Professional | | $0.21 | $0.21 | $0.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $75.86 / $75.86
| Professional | | $64.57 | $75.86 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.19 / $0.22 / $0.40
| Facility | | $0.19 | $0.22 | $0.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.30 / $0.40 / $1.48
| Facility | | $0.30 | $0.40 | $1.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.23 / $0.30 / $0.39
| Professional | | $0.23 | $0.30 | $0.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.21 / $0.25
| Facility | | $0.21 | $0.21 | $0.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.21 / $0.24
| Professional | | $0.21 | $0.21 | $0.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.08 / $0.08 / $0.19
| Facility | | $0.08 | $0.08 | $0.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.19 / $0.20 / $0.20
| Professional | | $0.19 | $0.20 | $0.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.20 / $0.21 / $0.27
| Professional | | $0.20 | $0.21 | $0.27 |