- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.19 / $2.19
| Facility | | $1.00 | $2.19 | $2.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.09 / $4.47
| Professional | | $1.00 | $2.09 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $1.02 / $1.02
| Professional | | $1.02 | $1.02 | $1.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $0.56 / $1.23
| Professional | | $0.50 | $0.56 | $1.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $1.02 / $1.02
| Professional | | $1.02 | $1.02 | $1.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.51 / $1.02 / $1.32
| Facility | | $0.51 | $1.02 | $1.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.66 / $1.29 / $1.38
| Professional | | $0.66 | $1.29 | $1.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.65 / $1.62
| Facility | | $0.62 | $0.65 | $1.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.52 / $1.07
| Professional | | $0.52 | $0.52 | $1.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.62 / $1.62
| Facility | | $0.56 | $0.62 | $1.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.52 / $0.65
| Professional | | $0.52 | $0.52 | $0.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.78 / $1.15
| Professional | | $0.71 | $0.78 | $1.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.98 / $1.12 / $2.14
| Professional | | $0.98 | $1.12 | $2.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $0.43 / $0.71
| Facility | | $0.32 | $0.43 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.48 / $0.71
| Professional | | $0.28 | $0.48 | $0.71 |