- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $2.95 / $3.80
| Facility | | $1.91 | $2.95 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $3.80
| Professional | | $1.00 | $1.00 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.48 / $3.02
| Facility | | $1.41 | $1.48 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.45 / $5.37
| Professional | | $1.41 | $1.45 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $2.51 / $3.55
| Facility | | $2.24 | $2.51 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.82 / $4.27
| Professional | | $1.41 | $1.82 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $2.24 / $3.02
| Facility | | $1.51 | $2.24 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $1.29 / $1.35
| Professional | | $1.29 | $1.29 | $1.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $1.55 / $3.24
| Professional | | $1.15 | $1.55 | $3.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $85.11 / $85.11
| Facility | | $79.43 | $85.11 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $2.09 / $3.24
| Facility | | $1.41 | $2.09 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $1.29 / $2.24
| Professional | | $1.29 | $1.29 | $2.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $3.55 / $3.55
| Professional | | $3.55 | $3.55 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $1.41 / $2.19
| Professional | | $1.02 | $1.41 | $2.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $6.61 / $6.61
| Facility | | $6.61 | $6.61 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.48 / $3.80
| Professional | | $1.41 | $1.48 | $3.80 |