- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $4.57 / $77.62
| Facility | | $1.41 | $4.57 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.91 / $1.82 / $3.72
| Professional | | $0.91 | $1.82 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $1.17 / $95.50
| Professional | | $1.17 | $1.17 | $95.50 |
- 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
- $0.76 / $0.76 / $0.76
| Professional | | $0.76 | $0.76 | $0.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.91 / $0.91 / $3.02
| Facility | | $0.91 | $0.91 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.69 / $0.69 / $0.83
| Professional | | $0.69 | $0.69 | $0.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $64.57 / $75.86
| Professional | | $64.57 | $64.57 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.76 / $0.76 / $1.58
| Facility | | $0.76 | $0.76 | $1.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.17 / $1.17
| Facility | | $1.07 | $1.17 | $1.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.98 / $1.07 / $1.07
| Professional | | $0.98 | $1.07 | $1.07 |
- 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
- $0.76 / $0.76 / $0.76
| Professional | | $0.76 | $0.76 | $0.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.66 / $0.66 / $1.55
| Facility | | $0.66 | $0.66 | $1.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.66 / $0.71 / $0.79
| Professional | | $0.66 | $0.71 | $0.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.69 / $0.71 / $0.89
| Professional | | $0.69 | $0.71 | $0.89 |