- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $8.71 / $34.67
| Facility | | $5.13 | $8.71 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.07 / $0.89 / $33.11
| Professional | | $0.07 | $0.89 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.02 / $0.02
| Professional | | $0.02 | $0.02 | $0.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.02 / $0.02
| Facility | | $0.02 | $0.02 | $0.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.02 / $0.02
| Professional | | $0.02 | $0.02 | $0.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.03 / $0.11 / $0.17
| Facility | | $0.03 | $0.11 | $0.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.02 / $0.05
| Professional | | $0.02 | $0.02 | $0.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.33 / $0.55
| Facility | | $0.02 | $0.33 | $0.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.02 / $0.10
| Professional | | $0.02 | $0.02 | $0.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.33 / $0.91 / $11.48
| Facility | | $0.33 | $0.91 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.46 / $524.81 / $524.81
| Professional | | $0.46 | $524.81 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $64.57 / $70.79
| Professional | | $33.11 | $64.57 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.02 / $0.04
| Professional | | $0.02 | $0.02 | $0.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.63 / $1.10
| Professional | | $0.02 | $0.63 | $1.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $85.11
| Facility | | $85.11 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.71 / $524.81
| Professional | | $0.05 | $0.71 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.03 / $0.03 / $0.03
| Professional | | $0.03 | $0.03 | $0.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.02 / $5.01
| Facility | | $0.02 | $0.02 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $72.44 / $87.10
| Professional | | $5.01 | $72.44 | $87.10 |