- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $63.10 / $426.58
| Facility | | $1.12 | $63.10 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $37.15 / $125.89
| Professional | | $1.51 | $37.15 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.23 / $0.25 / $0.34
| Facility | | $0.23 | $0.25 | $0.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.23 / $0.49
| Professional | | $0.22 | $0.23 | $0.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $0.50 / $0.50
| Facility | | $0.50 | $0.50 | $0.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.22 / $0.43
| Professional | | $0.16 | $0.22 | $0.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.23 / $0.39 / $0.52
| Facility | | $0.23 | $0.39 | $0.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.22 / $0.28
| Professional | | $0.22 | $0.22 | $0.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.22 / $0.28
| Professional | | $0.21 | $0.22 | $0.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.20 / $0.25 / $0.49
| Professional | | $0.20 | $0.25 | $0.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $575.44 / $575.44
| Professional | | $575.44 | $575.44 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.22 / $0.22
| Professional | | $0.22 | $0.22 | $0.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.26 / $0.52
| Facility | | $0.22 | $0.26 | $0.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.22 / $0.31
| Professional | | $0.22 | $0.22 | $0.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.41 / $0.41
| Professional | | $0.41 | $0.41 | $0.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $0.23 / $0.36
| Professional | | $0.17 | $0.23 | $0.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $0.65 / $0.65
| Facility | | $0.65 | $0.65 | $0.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.22 / $0.54
| Professional | | $0.22 | $0.22 | $0.54 |