- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.75 / $8.13
| Facility | | $1.00 | $2.75 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.52 / $1.70
| Professional | | $0.41 | $0.52 | $1.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $33.11 / $38.90
| Professional | | $33.11 | $33.11 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.48 / $0.95 / $2.88
| Facility | | $0.48 | $0.95 | $2.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.44 / $0.44 / $0.72
| Professional | | $0.44 | $0.44 | $0.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.39 / $0.39
| Facility | | $0.28 | $0.39 | $0.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.39 / $0.52
| Professional | | $0.35 | $0.39 | $0.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.54 / $0.87 / $1.48
| Facility | | $0.54 | $0.87 | $1.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.44 / $0.44 / $0.54
| Professional | | $0.44 | $0.44 | $0.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.40 / $2.45
| Facility | | $0.38 | $0.40 | $2.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.40 / $0.76
| Professional | | $0.38 | $0.40 | $0.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.39 / $0.44 / $0.58
| Professional | | $0.39 | $0.44 | $0.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.44 / $0.74 / $0.89
| Professional | | $0.44 | $0.74 | $0.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.14 / $0.36 / $0.78
| Facility | | $0.14 | $0.36 | $0.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.40 / $0.45
| Professional | | $0.16 | $0.40 | $0.45 |