- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $8.32 / $67.61
| Facility | | $1.23 | $8.32 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $1.38 / $6.92
| Professional | | $0.65 | $1.38 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $83.18 / $83.18
| Professional | | $83.18 | $83.18 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.76 / $1.51 / $4.57
| Facility | | $0.76 | $1.51 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.79 / $1.23
| Professional | | $0.71 | $0.79 | $1.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.93 / $0.93 / $0.93
| Facility | | $0.93 | $0.93 | $0.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $0.65 / $0.65
| Facility | | $0.65 | $0.65 | $0.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.87 / $0.87 / $0.87
| Professional | | $0.87 | $0.87 | $0.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $1.48 / $2.29
| Facility | | $1.32 | $1.48 | $2.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.71 / $0.71 / $0.71
| Professional | | $0.71 | $0.71 | $0.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $8.32 / $51.29
| Facility | | $2.63 | $8.32 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $0.66 / $138.04
| Professional | | $0.60 | $0.66 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $0.81 / $0.93
| Professional | | $0.65 | $0.81 | $0.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $1.17 / $1.62
| Professional | | $0.65 | $1.17 | $1.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.76 / $1.32 / $1.32
| Facility | | $0.76 | $1.32 | $1.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.66 / $0.71
| Professional | | $0.62 | $0.66 | $0.71 |