- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.23 / $1.35
| Facility | | $1.12 | $1.23 | $1.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $2.04 / $3.80
| Professional | | $1.05 | $2.04 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.93 / $1.10 / $1.38
| Facility | | $0.93 | $1.10 | $1.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.72 / $5.25
| Professional | | $0.62 | $0.72 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $2.51 / $2.75
| Facility | | $2.24 | $2.51 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.78 / $2.29
| Professional | | $0.62 | $0.78 | $2.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.45 / $2.51
| Facility | | $1.00 | $1.45 | $2.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1.10
| Professional | | $1.00 | $1.00 | $1.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.79 / $0.79 / $1.07
| Professional | | $0.79 | $0.79 | $1.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.55 / $0.79 / $1.48
| Professional | | $0.55 | $0.79 | $1.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $85.11
| Facility | | $85.11 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $9.77
| Professional | | $9.77 | $9.77 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.79 / $0.79 / $60.26
| Professional | | $0.79 | $0.79 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.68 / $1.78
| Facility | | $0.62 | $0.68 | $1.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1.23
| Professional | | $1.00 | $1.00 | $1.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.81 / $1.00 / $1.51
| Professional | | $0.81 | $1.00 | $1.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.62 / $3.89
| Professional | | $0.62 | $0.62 | $3.89 |