- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $6.76 / $32.36
| Facility | | $2.45 | $6.76 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.14 / $13.49
| Professional | | $1.00 | $2.14 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $1.62 / $1.62
| Professional | | $1.20 | $1.62 | $1.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $2.51 / $4.37
| Facility | | $2.19 | $2.51 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.41 / $2.04
| Professional | | $1.12 | $1.41 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $1.62 / $1.62
| Facility | | $1.62 | $1.62 | $1.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $1.91 / $1.91
| Professional | | $1.91 | $1.91 | $1.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.51 / $2.95
| Facility | | $2.34 | $2.51 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $2.34 / $3.24
| Professional | | $1.55 | $2.34 | $3.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $2.82 / $10.00
| Facility | | $1.55 | $2.82 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $2.24 / $4.37
| Professional | | $1.15 | $2.24 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $10.00 / $27.54
| Facility | | $3.09 | $10.00 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $2.09 / $7.08
| Professional | | $0.95 | $2.09 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $2.14 / $2.95
| Professional | | $1.78 | $2.14 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $2.82 / $5.13
| Facility | | $2.82 | $2.82 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $2.63 / $5.50
| Professional | | $1.66 | $2.63 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $2.34 / $3.55
| Facility | | $1.20 | $2.34 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $2.09 / $3.31
| Professional | | $1.41 | $2.09 | $3.31 |