- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $407.38 / $1,096.48
| Facility | | $1.07 | $407.38 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $134.90 / $478.63
| Professional | | $1.41 | $134.90 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.31 / $0.37 / $5,011.87
| Facility | | $0.31 | $0.37 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.36 / $0.36
| Professional | | $0.36 | $0.36 | $0.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $1.23 / $1.32
| Facility | | $0.35 | $1.23 | $1.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.35 / $0.35
| Professional | | $0.35 | $0.35 | $0.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.35 / $0.35
| Facility | | $0.35 | $0.35 | $0.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.62 / $0.62
| Professional | | $0.52 | $0.62 | $0.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.27 / $0.98 / $3.09
| Facility | | $0.27 | $0.98 | $3.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $3.24 / $39.81
| Facility | | $1.02 | $3.24 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $1.02 / $1.02
| Professional | | $1.02 | $1.02 | $1.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.24 / $0.25 / $0.52
| Facility | | $0.24 | $0.25 | $0.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.07 / $0.25 / $0.52
| Professional | | $0.07 | $0.25 | $0.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.35 / $0.35
| Facility | | $0.35 | $0.35 | $0.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.39 / $0.65
| Professional | | $0.35 | $0.39 | $0.65 |