- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.82 / $3.31
| Facility | | $1.38 | $1.82 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $2.34
| Professional | | $1.00 | $1.00 | $2.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $1.45
| Facility | | $1.38 | $1.38 | $1.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $1.38
| Professional | | $1.38 | $1.38 | $1.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $1.17 / $1.23
| Facility | | $1.17 | $1.17 | $1.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $1.17 / $1.17
| Professional | | $1.17 | $1.17 | $1.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $1.82 / $2.04
| Facility | | $1.23 | $1.82 | $2.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $5.89
| Professional | | $1.38 | $1.38 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $1.55 / $4.68
| Facility | | $1.17 | $1.55 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.41 / $2.24
| Professional | | $1.41 | $1.41 | $2.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.41 / $1.48
| Facility | | $1.41 | $1.41 | $1.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.41 / $1.41
| Professional | | $1.41 | $1.41 | $1.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $50,118.72 / $75,857.76
| Facility | | $1.74 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $2.29
| Facility | | $1.38 | $1.38 | $2.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.45 / $2.82
| Professional | | $1.38 | $1.45 | $2.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.41 / $1.62
| Facility | | $1.41 | $1.41 | $1.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.98 / $1.41 / $1.70
| Professional | | $0.98 | $1.41 | $1.70 |