- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.82 / $3.63
| Facility | | $1.26 | $1.82 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $2.04
| Professional | | $1.00 | $1.00 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $1.29 / $1.29
| Facility | | $1.29 | $1.29 | $1.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $1.02 / $1.29
| Professional | | $1.02 | $1.02 | $1.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $2.82 / $4.07
| Facility | | $1.38 | $2.82 | $4.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $1.55 / $2.24
| Professional | | $1.02 | $1.55 | $2.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $1.48 / $3.55
| Facility | | $1.48 | $1.48 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $2.95 / $2.95
| Professional | | $2.19 | $2.95 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.41 / $2.88
| Facility | | $1.41 | $1.41 | $2.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.58 / $2.95
| Professional | | $1.41 | $1.58 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $64.57 / $85.11
| Professional | | $1.23 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $1.74 / $1.74
| Facility | | $1.74 | $1.74 | $1.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $1.58 / $3.98
| Professional | | $1.02 | $1.58 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $1.20 / $85.11
| Facility | | $1.20 | $1.20 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $1.20 / $1.20
| Professional | | $1.20 | $1.20 | $1.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $2.14
| Professional | | $1.38 | $1.38 | $2.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.26 / $2.95
| Facility | | $1.26 | $1.26 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $1.35 / $1.78
| Professional | | $1.23 | $1.35 | $1.78 |