- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $2.00 / $134.90
| Facility | | $1.15 | $2.00 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $2.14 / $31.62
| Professional | | $1.05 | $2.14 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $1.05 / $1.26
| Facility | | $1.05 | $1.05 | $1.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.79 / $0.79 / $0.79
| Professional | | $0.79 | $0.79 | $0.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.72 / $1.23 / $85.11
| Facility | | $0.72 | $1.23 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.72 / $0.72 / $0.81
| Professional | | $0.72 | $0.72 | $0.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.76 / $0.79 / $1.02
| Professional | | $0.76 | $0.79 | $1.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.72 / $0.72 / $4.17
| Facility | | $0.72 | $0.72 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.78 / $0.95 / $1.58
| Professional | | $0.78 | $0.95 | $1.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.10 / $2.04
| Facility | | $1.07 | $1.10 | $2.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.70 / $10.00
| Professional | | $1.00 | $1.70 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $1.82 / $30.20
| Professional | | $0.60 | $1.82 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.81 / $1.00 / $2.95
| Facility | | $0.81 | $1.00 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $0.93 / $2.95
| Professional | | $0.45 | $0.93 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.78 / $0.81 / $1.29
| Professional | | $0.78 | $0.81 | $1.29 |