- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.29 / $1.70
| Facility | | $1.12 | $1.29 | $1.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $1.70 / $15.14
| Professional | | $1.70 | $1.70 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.71 / $0.71
| Facility | | $0.71 | $0.71 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.56 / $0.72
| Professional | | $0.56 | $0.56 | $0.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.69 / $1.26 / $1.86
| Facility | | $0.69 | $1.26 | $1.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.71 / $1.05
| Professional | | $0.56 | $0.71 | $1.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.39 / $0.39 / $1.66
| Facility | | $0.39 | $0.39 | $1.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.59 / $0.78 / $0.79
| Professional | | $0.59 | $0.78 | $0.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.51 / $0.51 / $1.66
| Facility | | $0.51 | $0.51 | $1.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.51 / $0.51 / $0.79
| Professional | | $0.51 | $0.51 | $0.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $64.57 / $85.11
| Professional | | $0.56 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.78 / $0.78 / $3.39
| Facility | | $0.78 | $0.78 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.56 / $2.19
| Professional | | $0.56 | $0.56 | $2.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.56 / $100.00
| Facility | | $0.56 | $0.56 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.56 / $0.56
| Professional | | $0.56 | $0.56 | $0.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.78 / $0.78 / $2.34
| Professional | | $0.78 | $0.78 | $2.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.30 / $0.30 / $0.71
| Facility | | $0.30 | $0.30 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.56 / $0.78
| Professional | | $0.56 | $0.56 | $0.78 |