- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $5.13 / $19.95
| Facility | | $1.82 | $5.13 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $5.01
| Professional | | $1.00 | $1.00 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $1.55 / $1.55
| Professional | | $1.55 | $1.55 | $1.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $2.82 / $2.95
| Facility | | $2.82 | $2.82 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $2.82 / $2.82
| Professional | | $2.82 | $2.82 | $2.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $2.04 / $3.16
| Facility | | $1.70 | $2.04 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $1.55 / $7.76
| Professional | | $1.55 | $1.55 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $1.91 / $5.37
| Facility | | $1.48 | $1.91 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $1.70 / $3.31
| Professional | | $1.70 | $1.70 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.82 / $1.91
| Facility | | $1.82 | $1.82 | $1.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.82 / $1.91
| Professional | | $1.82 | $1.82 | $1.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.93 / $3.55 / $6.61
| Facility | | $0.93 | $3.55 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.09 / $2.09
| Professional | | $2.09 | $2.09 | $2.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $50,118.72 / $75,857.76
| Facility | | $2.29 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $1.91 / $3.80
| Facility | | $1.91 | $1.91 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.91 / $5.25
| Professional | | $1.82 | $1.91 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.82 / $2.19
| Facility | | $1.82 | $1.82 | $2.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.91 / $3.39
| Professional | | $1.82 | $1.91 | $3.39 |