- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $47.86 / $52.48
| Facility | | $1.05 | $47.86 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $12.88
| Professional | | $1.00 | $1.00 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $6.31 / $10.47
| Facility | | $3.16 | $6.31 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $8.91 / $9.33
| Professional | | $1.12 | $8.91 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $1.23 / $2.95
| Facility | | $1.20 | $1.23 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.10 / $4.37
| Professional | | $1.10 | $1.10 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.15 / $17.78
| Facility | | $1.10 | $1.15 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.20 / $5.89
| Professional | | $1.00 | $1.20 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.00 / $1.00
| Professional | | $1.00 | $1.00 | $1.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $1.29 / $1.29
| Facility | | $1.29 | $1.29 | $1.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $1.20 / $1.32
| Professional | | $1.05 | $1.20 | $1.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.10 / $1.10
| Professional | | $1.10 | $1.10 | $1.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.48 / $0.48 / $0.60
| Facility | | $0.48 | $0.48 | $0.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.42 / $1.05 / $1.20
| Professional | | $0.42 | $1.05 | $1.20 |