- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.51 / $2.29
| Facility | | $1.07 | $1.51 | $2.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.51 / $2.51
| Professional | | $1.00 | $2.51 | $2.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.66 / $0.66 / $0.66
| Facility | | $0.66 | $0.66 | $0.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.66 / $0.66 / $0.66
| Professional | | $0.66 | $0.66 | $0.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.87 / $0.87 / $3.02
| Facility | | $0.87 | $0.87 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $0.65 / $0.79
| Professional | | $0.65 | $0.65 | $0.79 |
- 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
- $0.71 / $1.05 / $1.41
| Facility | | $0.71 | $1.05 | $1.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.93 / $3.24 / $3.24
| Facility | | $0.93 | $3.24 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.93 / $0.93
| Professional | | $0.68 | $0.93 | $0.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.66 / $0.66 / $0.66
| Facility | | $0.66 | $0.66 | $0.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.66 / $0.66 / $0.66
| Professional | | $0.66 | $0.66 | $0.66 |
- 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 / $0.72 / $0.72
| Professional | | $0.66 | $0.72 | $0.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.72 / $0.85 / $0.93
| Professional | | $0.72 | $0.85 | $0.93 |