- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $4.47 / $81.28
| Facility | | $1.26 | $4.47 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.15 / $3.02
| Professional | | $1.00 | $1.15 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $1.05 / $1.05
| Facility | | $1.05 | $1.05 | $1.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $1.05 / $1.05
| Professional | | $1.05 | $1.05 | $1.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.26 / $4.37
| Facility | | $1.26 | $1.26 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $0.95 / $1.17
| Professional | | $0.95 | $0.95 | $1.17 |
- 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
- $0.93 / $1.62 / $2.24
| Facility | | $0.93 | $1.62 | $2.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $2.19 / $2.19
| Facility | | $1.51 | $2.19 | $2.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.51 / $1.51
| Professional | | $1.07 | $1.51 | $1.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $1.05 / $1.05
| Facility | | $1.05 | $1.05 | $1.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $1.05 / $1.05
| Professional | | $1.05 | $1.05 | $1.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $2.63
| Facility | | $1.12 | $1.12 | $2.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.07 / $1.29
| Professional | | $1.07 | $1.07 | $1.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.07 / $1.23
| Professional | | $1.07 | $1.07 | $1.23 |