- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $5.62 / $75.86
| Facility | | $1.48 | $5.62 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.85 / $1.70 / $3.72
| Professional | | $0.85 | $1.70 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $2.24 / $70.79
| Professional | | $2.24 | $2.24 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.74 / $0.79 / $1.07
| Facility | | $0.74 | $0.79 | $1.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.74 / $2.04
| Professional | | $0.71 | $0.74 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $1.20 / $1.62
| Facility | | $1.20 | $1.20 | $1.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.93 / $2.40
| Professional | | $0.71 | $0.93 | $2.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.72 / $1.17 / $1.58
| Facility | | $0.72 | $1.17 | $1.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.69 / $0.69 / $0.71
| Professional | | $0.69 | $0.69 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.78 / $2.00
| Professional | | $0.62 | $0.78 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.72 / $0.72 / $0.72
| Professional | | $0.72 | $0.72 | $0.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $1.05 / $1.86
| Facility | | $0.71 | $1.05 | $1.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.69 / $0.69 / $1.20
| Professional | | $0.69 | $0.69 | $1.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $1.15 / $1.15
| Professional | | $1.15 | $1.15 | $1.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.55 / $0.76 / $1.17
| Professional | | $0.55 | $0.76 | $1.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $2.82 / $2.82
| Facility | | $2.82 | $2.82 | $2.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.76 / $1.95
| Professional | | $0.71 | $0.76 | $1.95 |