- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $380.19 / $691.83
| Facility | | $1.29 | $380.19 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $100.00 / $107.15
| Professional | | $1.29 | $100.00 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.33 / $0.68
| Facility | | $0.28 | $0.33 | $0.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.32 / $1.12
| Professional | | $0.28 | $0.32 | $1.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.76 / $1.07
| Facility | | $0.71 | $0.76 | $1.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.37 / $0.89
| Professional | | $0.28 | $0.37 | $0.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.39 / $0.56
| Facility | | $0.28 | $0.39 | $0.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.28 / $0.28
| Professional | | $0.28 | $0.28 | $0.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $0.30 / $0.76
| Professional | | $0.25 | $0.30 | $0.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $85.11 / $85.11
| Facility | | $79.43 | $85.11 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.41 / $0.71
| Facility | | $0.28 | $0.41 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.28 / $0.28
| Professional | | $0.28 | $0.28 | $0.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.41 / $1.41
| Professional | | $1.41 | $1.41 | $1.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.23 / $0.31 / $0.48
| Professional | | $0.23 | $0.31 | $0.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $2.14 / $2.14
| Facility | | $0.28 | $2.14 | $2.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.30 / $0.78
| Professional | | $0.28 | $0.30 | $0.78 |