- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.29 / $4.27
| Facility | | $1.07 | $1.29 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.29 / $7.59
| Professional | | $1.07 | $1.29 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.69 / $2.09
| Facility | | $0.35 | $0.69 | $2.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $0.34 / $0.56
| Professional | | $0.32 | $0.34 | $0.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.20 / $0.27 / $0.27
| Facility | | $0.20 | $0.27 | $0.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.24 / $0.27 / $0.36
| Professional | | $0.24 | $0.27 | $0.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.45 / $0.68 / $1.05
| Facility | | $0.45 | $0.68 | $1.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $0.32 / $2.19
| Professional | | $0.32 | $0.32 | $2.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $0.38 / $2.19
| Facility | | $0.36 | $0.38 | $2.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.38 / $0.38 / $2.57
| Professional | | $0.38 | $0.38 | $2.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.27 / $0.38 / $0.54
| Professional | | $0.27 | $0.38 | $0.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $0.54 / $0.65
| Professional | | $0.32 | $0.54 | $0.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.28 / $0.60
| Facility | | $0.11 | $0.28 | $0.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.38 / $0.42
| Professional | | $0.15 | $0.38 | $0.42 |