- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.63 / $5.37
| Facility | | $1.86 | $2.63 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $2.40
| Professional | | $1.00 | $1.00 | $2.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $1.86 / $1.86
| Professional | | $1.86 | $1.86 | $1.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $1.51 / $1.58
| Facility | | $1.51 | $1.51 | $1.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $1.51 / $1.51
| Professional | | $1.51 | $1.51 | $1.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $2.45 / $85.11
| Facility | | $1.51 | $2.45 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $1.86 / $2.04
| Professional | | $1.86 | $1.86 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $2.29 / $6.31
| Facility | | $1.78 | $2.29 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.04 / $2.34
| Professional | | $1.95 | $2.04 | $2.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.82 / $1.91
| Facility | | $1.82 | $1.82 | $1.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.91 / $1.91
| Professional | | $1.82 | $1.91 | $1.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.34 / $2.34
| Facility | | $2.34 | $2.34 | $2.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $50,118.72 / $75,857.76
| Facility | | $2.34 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.00 / $2.00
| Professional | | $2.00 | $2.00 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $1.95 / $2.09
| Facility | | $1.95 | $1.95 | $2.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $1.91 / $2.19
| Professional | | $1.86 | $1.91 | $2.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.82 / $2.19
| Facility | | $1.82 | $1.82 | $2.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.91 / $1.91
| Professional | | $1.82 | $1.91 | $1.91 |