- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $95.50 / $933.25
| Facility | | $28.84 | $95.50 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $72.44 / $245.47
| Professional | | $23.44 | $72.44 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.96 / $15.14
| Professional | | $10.00 | $10.96 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.26 / $0.39
| Facility | | $0.16 | $0.26 | $0.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.15 / $0.19
| Professional | | $0.15 | $0.15 | $0.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $0.17 / $0.17
| Professional | | $0.17 | $0.17 | $0.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.33 / $0.43
| Facility | | $0.21 | $0.33 | $0.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.15 / $0.15
| Professional | | $0.15 | $0.15 | $0.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.15 / $0.40
| Facility | | $0.11 | $0.15 | $0.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.12 / $85.11
| Professional | | $0.11 | $0.12 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $0.17 / $0.20
| Facility | | $0.17 | $0.17 | $0.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.10 / $0.11 / $1.26
| Professional | | $0.10 | $0.11 | $1.26 |