- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $6.03 / $6.03
| Professional | | $1.95 | $6.03 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.46 / $0.46 / $0.76
| Facility | | $0.46 | $0.46 | $0.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.43 / $0.51
| Professional | | $0.41 | $0.43 | $0.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.27 / $1.05 / $1.70
| Facility | | $0.27 | $1.05 | $1.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.23 / $0.47 / $0.85
| Professional | | $0.23 | $0.47 | $0.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $0.39 / $0.65
| Facility | | $0.25 | $0.39 | $0.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.42 / $0.89 / $1.10
| Professional | | $0.42 | $0.89 | $1.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $0.45 / $79.43
| Facility | | $0.26 | $0.45 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.19 / $0.23 / $0.52
| Professional | | $0.19 | $0.23 | $0.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.37 / $33.11 / $70.79
| Professional | | $0.37 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.76 / $0.76 / $0.76
| Facility | | $0.76 | $0.76 | $0.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.34 / $0.52 / $0.89
| Professional | | $0.34 | $0.52 | $0.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.46 / $0.69 / $1.05
| Professional | | $0.46 | $0.69 | $1.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.27 / $0.91 / $79.43
| Facility | | $0.27 | $0.91 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.23 / $0.46 / $3.72
| Professional | | $0.23 | $0.46 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.46 / $0.46 / $0.46
| Professional | | $0.46 | $0.46 | $0.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.46 / $0.46 / $0.46
| Professional | | $0.46 | $0.46 | $0.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.14 / $0.22 / $0.46
| Facility | | $0.14 | $0.22 | $0.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.23 / $0.38
| Professional | | $0.15 | $0.23 | $0.38 |