- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $51.29 / $363.08
| Facility | | $7.41 | $51.29 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $32.36 / $125.89
| Professional | | $6.31 | $32.36 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.66 / $0.78 / $5,011.87
| Facility | | $0.66 | $0.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.78 / $0.78 / $0.78
| Professional | | $0.78 | $0.78 | $0.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.78 / $0.83
| Facility | | $0.22 | $0.78 | $0.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.22 / $0.22
| Professional | | $0.22 | $0.22 | $0.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.24 / $0.24 / $0.24
| Professional | | $0.24 | $0.24 | $0.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.22 / $0.22
| Facility | | $0.22 | $0.22 | $0.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.23 / $0.38 / $0.63
| Professional | | $0.23 | $0.38 | $0.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.49 / $0.65 / $2.69
| Facility | | $0.49 | $0.65 | $2.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.28 / $0.28
| Professional | | $0.28 | $0.28 | $0.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.62 / $0.62
| Facility | | $0.62 | $0.62 | $0.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.30 / $0.40 / $0.60
| Professional | | $0.30 | $0.40 | $0.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $0.24 / $0.52
| Facility | | $0.17 | $0.24 | $0.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $0.21 / $0.52
| Professional | | $0.17 | $0.21 | $0.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.22 / $0.56
| Professional | | $0.22 | $0.22 | $0.56 |