- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $8.71 / $72.44
| Facility | | $1.15 | $8.71 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $3.02
| Professional | | $1.00 | $1.00 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.10 / $1.10
| Professional | | $1.10 | $1.10 | $1.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.41 / $1.48
| Facility | | $1.41 | $1.41 | $1.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.41 / $1.41
| Professional | | $1.41 | $1.41 | $1.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $1.45 / $1.62
| Facility | | $1.17 | $1.45 | $1.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.10 / $7.94
| Professional | | $1.10 | $1.10 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $1.86 / $3.80
| Facility | | $1.02 | $1.86 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $1.17 / $1.95
| Professional | | $1.17 | $1.17 | $1.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.07 / $1.12
| Facility | | $1.07 | $1.07 | $1.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.07 / $1.12
| Professional | | $1.07 | $1.07 | $1.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.55 / $2.14 / $7.76
| Facility | | $0.55 | $2.14 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $3.80 / $53,703.18
| Facility | | $1.23 | $3.80 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $1.23 / $2.40
| Facility | | $1.23 | $1.23 | $2.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.15 / $5.25
| Professional | | $1.10 | $1.15 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.07 / $1.29
| Facility | | $1.07 | $1.07 | $1.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.12 / $3.24
| Professional | | $1.07 | $1.12 | $3.24 |