- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $8.32 / $48.98
| Facility | | $1.45 | $8.32 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $2.29 / $3.55
| Professional | | $1.17 | $2.29 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.68 / $1.12
| Professional | | $0.68 | $0.68 | $1.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $1.48 / $2.24
| Professional | | $1.29 | $1.48 | $2.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.93 / $1.26 / $1.70
| Facility | | $0.93 | $1.26 | $1.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.68 / $0.68
| Professional | | $0.68 | $0.68 | $0.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.65 / $3.55
| Professional | | $0.56 | $0.65 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.55 / $0.55 / $0.55
| Professional | | $0.55 | $0.55 | $0.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $2.29 / $3.39
| Facility | | $0.65 | $2.29 | $3.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $0.81 / $2.04
| Facility | | $0.65 | $0.81 | $2.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $0.81 / $2.04
| Professional | | $0.65 | $0.81 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $1.45
| Facility | | $1.12 | $1.12 | $1.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.63 / $0.65 / $0.83
| Professional | | $0.63 | $0.65 | $0.83 |