- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $47.86 / $91.20
| Facility | | $7.59 | $47.86 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $19.95
| Professional | | $1.00 | $1.00 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $1.15 / $1.74
| Professional | | $1.15 | $1.15 | $1.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $1.35 / $1.82
| Facility | | $0.95 | $1.35 | $1.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $1.07 / $1.29
| Professional | | $0.95 | $1.07 | $1.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $3.24 / $5.62
| Facility | | $1.51 | $3.24 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.32 / $4.27
| Professional | | $1.07 | $1.32 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $0.98 / $1.78
| Facility | | $0.95 | $0.98 | $1.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $1.35 / $1.91
| Professional | | $1.32 | $1.35 | $1.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.82 / $10.72
| Facility | | $1.00 | $1.82 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.82 / $524.81
| Professional | | $1.82 | $1.82 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $1.82 / $70.79
| Professional | | $0.95 | $1.82 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $1.45 / $1.95
| Facility | | $1.45 | $1.45 | $1.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $1.26 / $2.51
| Professional | | $0.95 | $1.26 | $2.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $1.58 / $3.31
| Professional | | $1.15 | $1.58 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $85.11 / $100.00
| Facility | | $1.05 | $85.11 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $2.19 / $524.81
| Professional | | $1.05 | $2.19 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.58 / $1.95
| Professional | | $1.12 | $1.58 | $1.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.93 / $0.93 / $2.19
| Facility | | $0.93 | $0.93 | $2.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.93 / $1.05 / $1.58
| Professional | | $0.93 | $1.05 | $1.58 |