- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $2.24 / $2.75
| Facility | | $1.35 | $2.24 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.38 / $5.01
| Professional | | $1.00 | $1.38 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.83 / $1.00 / $5,011.87
| Facility | | $0.83 | $1.00 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $0.95 / $0.95
| Professional | | $0.95 | $0.95 | $0.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.81 / $2.82 / $3.02
| Facility | | $0.81 | $2.82 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.81 / $0.81 / $1.17
| Professional | | $0.81 | $0.81 | $1.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $2.63 / $2.82
| Professional | | $0.71 | $2.63 | $2.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.81 / $0.81 / $0.81
| Facility | | $0.81 | $0.81 | $0.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.81 / $0.81 / $1.41
| Professional | | $0.81 | $0.81 | $1.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $2.40 / $9.77
| Facility | | $1.23 | $2.40 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1.23
| Professional | | $1.00 | $1.00 | $1.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.51 / $0.51 / $1.91
| Facility | | $0.51 | $0.51 | $1.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.51 / $1.41 / $1.91
| Professional | | $0.51 | $1.41 | $1.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.03 / $0.12 / $0.27
| Facility | | $0.03 | $0.12 | $0.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.91 / $1.51
| Professional | | $0.36 | $0.91 | $1.51 |