- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $12.59 / $269.15
| Facility | | $1.62 | $12.59 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.83 / $5.01 / $95.50
| Professional | | $0.83 | $5.01 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $39.81 / $39.81
| Professional | | $25.70 | $39.81 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.43 / $0.43
| Professional | | $0.43 | $0.43 | $0.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.34 / $0.56 / $85.11
| Facility | | $0.34 | $0.56 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.43 / $0.47
| Professional | | $0.43 | $0.43 | $0.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.47 / $0.52 / $1.48
| Facility | | $0.47 | $0.52 | $1.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.40 / $0.47 / $0.47
| Professional | | $0.40 | $0.47 | $0.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $0.45 / $0.47
| Facility | | $0.45 | $0.45 | $0.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $0.47 / $0.47
| Professional | | $0.45 | $0.47 | $0.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $0.65 / $9.33
| Facility | | $0.32 | $0.65 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $50,118.72 / $53,703.18
| Facility | | $0.50 | $50,118.72 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.02 / $0.04 / $0.83
| Professional | | $0.02 | $0.04 | $0.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $0.45 / $0.72
| Facility | | $0.45 | $0.45 | $0.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.40 / $0.40 / $0.63
| Professional | | $0.40 | $0.40 | $0.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.45 / $0.49
| Facility | | $0.41 | $0.45 | $0.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $0.47 / $0.47
| Professional | | $0.45 | $0.47 | $0.47 |