- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.09 / $5.62
| Facility | | $2.19 | $3.09 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.00 / $3.72
| Professional | | $2.00 | $2.00 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $1.78 / $7.76
| Professional | | $1.78 | $1.78 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $10.47
| Facility | | $9.77 | $9.77 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $9.77
| Professional | | $9.77 | $9.77 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.34 / $11.75
| Facility | | $1.95 | $2.34 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $1.78 / $11.48
| Professional | | $1.78 | $1.78 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $2.19 / $6.03
| Facility | | $1.70 | $2.19 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.95 / $18.20
| Professional | | $1.26 | $1.95 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $2.75 / $2.88
| Facility | | $2.75 | $2.75 | $2.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $2.82 / $2.82
| Professional | | $2.75 | $2.82 | $2.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $26.30 / $26.30
| Facility | | $26.30 | $26.30 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $50,118.72 / $75,857.76
| Facility | | $2.51 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $1.78 / $1.91
| Facility | | $0.17 | $1.78 | $1.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.87 / $2.19 / $16.22
| Professional | | $0.87 | $2.19 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $2.75 / $3.31
| Facility | | $2.75 | $2.75 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $2.82 / $3.31
| Professional | | $2.75 | $2.82 | $3.31 |