- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $38.02 / $93.33
| Facility | | $1.45 | $38.02 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.05 / $46.77
| Professional | | $1.00 | $1.05 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $1.58
| Facility | | $1.12 | $1.12 | $1.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $1.12
| Professional | | $1.12 | $1.12 | $1.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $1.12 / $5,011.87
| Facility | | $0.95 | $1.12 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.07 / $1.07
| Professional | | $1.07 | $1.07 | $1.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.89 / $3.16 / $3.39
| Facility | | $0.89 | $3.16 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.89 / $0.89 / $0.93
| Professional | | $0.89 | $0.89 | $0.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.93 / $0.98 / $1.12
| Professional | | $0.93 | $0.98 | $1.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.89 / $0.89 / $0.89
| Facility | | $0.89 | $0.89 | $0.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $1.00 / $1.91
| Professional | | $0.50 | $1.00 | $1.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $19.05 / $64.57
| Facility | | $2.57 | $19.05 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $5.01 / $5.25
| Professional | | $1.20 | $5.01 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $1.58
| Facility | | $1.12 | $1.12 | $1.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $1.12
| Professional | | $1.12 | $1.12 | $1.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $1.48 / $2.75
| Facility | | $1.15 | $1.48 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1.70
| Professional | | $1.00 | $1.00 | $1.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $1.58 / $30.20
| Professional | | $0.60 | $1.58 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.39 / $1.05 / $1.10
| Facility | | $0.39 | $1.05 | $1.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.30 / $0.95 / $158.49
| Professional | | $0.30 | $0.95 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $1.15 / $3.63
| Professional | | $1.05 | $1.15 | $3.63 |