- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $1.86 / $3.72
| Facility | | $1.29 | $1.86 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $2.09
| Professional | | $1.00 | $1.00 | $2.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $1.55 / $2.82
| Facility | | $1.55 | $1.55 | $2.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.26 / $1.58
| Professional | | $1.26 | $1.26 | $1.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $2.95 / $4.37
| Facility | | $1.62 | $2.95 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.58 / $2.29
| Professional | | $1.26 | $1.58 | $2.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.83 / $1.26 / $1.26
| Facility | | $0.83 | $1.26 | $1.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.51 / $2.51
| Professional | | $1.86 | $2.51 | $2.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.83 / $1.23 / $1.23
| Facility | | $0.83 | $1.23 | $1.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $1.23 / $1.95
| Professional | | $1.23 | $1.23 | $1.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $64.57 / $85.11
| Professional | | $1.23 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $1.26 / $1.95
| Facility | | $1.23 | $1.26 | $1.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.48 / $4.37
| Professional | | $1.26 | $1.48 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $1.23 / $100.00
| Facility | | $1.23 | $1.23 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $1.23 / $1.23
| Professional | | $1.23 | $1.23 | $1.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.70 / $2.09
| Professional | | $1.26 | $1.70 | $2.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $1.20 / $2.82
| Facility | | $1.20 | $1.20 | $2.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $1.23 / $1.70
| Professional | | $1.23 | $1.23 | $1.70 |