- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.82 / $3.72
| Facility | | $1.86 | $2.82 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $3.31
| Professional | | $1.00 | $1.00 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $1.66 / $3.24
| Facility | | $1.45 | $1.66 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $3.39
| Professional | | $1.38 | $1.38 | $3.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $1.86 / $2.57
| Facility | | $1.78 | $1.86 | $2.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.78 / $4.07
| Professional | | $1.38 | $1.78 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $2.34 / $3.16
| Facility | | $1.41 | $2.34 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $1.41
| Professional | | $1.38 | $1.38 | $1.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $1.51 / $3.24
| Professional | | $1.23 | $1.51 | $3.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.35 / $1.35
| Professional | | $1.35 | $1.35 | $1.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $2.09 / $3.24
| Facility | | $1.38 | $2.09 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $2.19
| Professional | | $1.38 | $1.38 | $2.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.04 / $2.04
| Professional | | $2.04 | $2.04 | $2.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.23 / $1.51
| Professional | | $1.10 | $1.23 | $1.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $3.89 / $3.89
| Facility | | $1.38 | $3.89 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $3.72
| Professional | | $1.38 | $1.38 | $3.72 |