- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $524.81 / $1,096.48
| Facility | | $1.20 | $524.81 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $1.55 / $2.00
| Professional | | $1.17 | $1.55 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.65 / $1.82
| Facility | | $0.38 | $0.65 | $1.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.41 / $0.66
| Professional | | $0.35 | $0.41 | $0.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.47 / $0.47 / $0.47
| Facility | | $0.47 | $0.47 | $0.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.46 / $0.46 / $0.46
| Facility | | $0.46 | $0.46 | $0.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.62 / $0.62
| Professional | | $0.62 | $0.62 | $0.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.59 / $0.98
| Facility | | $0.35 | $0.59 | $0.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.35 / $0.59
| Professional | | $0.35 | $0.35 | $0.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.27 / $0.35 / $1.29
| Facility | | $0.27 | $0.35 | $1.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.35 / $1.48
| Professional | | $0.35 | $0.35 | $1.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.49 / $0.65
| Professional | | $0.35 | $0.49 | $0.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.33 / $0.56 / $0.81
| Professional | | $0.33 | $0.56 | $0.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.35 / $0.71
| Facility | | $0.35 | $0.35 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.33 / $0.39 / $0.43
| Professional | | $0.33 | $0.39 | $0.43 |