- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $38.02 / $186.21
| Facility | | $2.69 | $38.02 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.83 / $3.02 / $89.13
| Professional | | $0.83 | $3.02 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $42.66 / $50.12
| Professional | | $37.15 | $42.66 | $50.12 |
- 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
- $0.71 / $0.83 / $5,011.87
| Facility | | $0.71 | $0.83 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.83 / $0.83 / $0.83
| Professional | | $0.83 | $0.83 | $0.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $1.51 / $1.62
| Facility | | $0.43 | $1.51 | $1.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.43 / $0.43
| Professional | | $0.43 | $0.43 | $0.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.47 / $0.47 / $0.47
| Professional | | $0.47 | $0.47 | $0.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.43 / $0.43
| Facility | | $0.43 | $0.43 | $0.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $0.95 / $1.38
| Professional | | $0.45 | $0.95 | $1.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.34 / $5.25 / $12.88
| Facility | | $0.34 | $5.25 | $12.88 |
- 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
- $1.07 / $1.26 / $21.88
| Facility | | $1.07 | $1.26 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $1.02 / $1.45
| Professional | | $1.02 | $1.02 | $1.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $0.60 / $1.91
| Professional | | $0.50 | $0.60 | $1.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.37 / $0.48 / $0.55
| Facility | | $0.37 | $0.48 | $0.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.37 / $0.48 / $0.52
| Professional | | $0.37 | $0.48 | $0.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.40 / $0.40 / $0.78
| Professional | | $0.40 | $0.40 | $0.78 |