- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $38.90 / $269.15
| Facility | | $3.63 | $38.90 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.81 / $3.02 / $30.90
| Professional | | $0.81 | $3.02 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $44.67 / $50.12
| Professional | | $33.88 | $44.67 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.46 / $0.91 / $2.82
| Facility | | $0.46 | $0.91 | $2.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.52 / $0.79
| Professional | | $0.43 | $0.52 | $0.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $3.39 / $3.39
| Facility | | $3.39 | $3.39 | $3.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $0.45 / $0.65
| Facility | | $0.45 | $0.45 | $0.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $0.45 / $0.62
| Professional | | $0.45 | $0.45 | $0.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.81 / $0.91 / $1.45
| Facility | | $0.81 | $0.91 | $1.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.43 / $0.49
| Professional | | $0.43 | $0.43 | $0.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $2.09 / $15.49
| Facility | | $0.38 | $2.09 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.40 / $0.40 / $0.56
| Professional | | $0.40 | $0.40 | $0.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.44 / $0.50 / $0.66
| Professional | | $0.44 | $0.50 | $0.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.56 / $0.85
| Professional | | $0.43 | $0.56 | $0.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $0.85 / $0.87
| Facility | | $0.50 | $0.85 | $0.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.40 / $0.40 / $0.58
| Professional | | $0.40 | $0.40 | $0.58 |