- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $3.55 / $4.79
| Facility | | $1.00 | $3.55 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1.32
| Professional | | $1.00 | $1.00 | $1.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $3.39 / $5.75
| Facility | | $1.70 | $3.39 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $1.70 / $2.82
| Professional | | $1.70 | $1.70 | $2.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.63 / $3.98
| Professional | | $2.34 | $2.63 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $3.24 / $4.27
| Facility | | $2.40 | $3.24 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $1.70 / $1.70
| Professional | | $1.70 | $1.70 | $1.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $1.70 / $2.04
| Professional | | $1.45 | $1.70 | $2.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.81 / $0.81 / $0.81
| Professional | | $0.81 | $0.81 | $0.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.50 / $1.32 / $2.63
| Facility | | $0.50 | $1.32 | $2.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $1.62 / $2.51
| Facility | | $1.51 | $1.62 | $2.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $1.62 / $2.51
| Professional | | $1.51 | $1.62 | $2.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $1.70 / $3.55
| Facility | | $1.66 | $1.70 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $1.70 / $1.86
| Professional | | $1.66 | $1.70 | $1.86 |