- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $4.47 / $28.84
| Facility | | $0.68 | $4.47 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.37 / $0.74 / $1.38
| Professional | | $0.37 | $0.74 | $1.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $33.11 / $33.11
| Professional | | $33.11 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.44 / $0.44 / $354.81
| Facility | | $0.44 | $0.44 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.37 / $0.43 / $5,011.87
| Facility | | $0.37 | $0.43 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.42 / $0.42 / $0.42
| Professional | | $0.42 | $0.42 | $0.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.44 / $0.72 / $1.66
| Facility | | $0.44 | $0.72 | $1.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.44 / $0.44 / $0.52
| Professional | | $0.44 | $0.44 | $0.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.39 / $2.82 / $3.02
| Professional | | $0.39 | $2.82 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.44 / $0.44 / $0.44
| Facility | | $0.44 | $0.44 | $0.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.44 / $0.76
| Professional | | $0.21 | $0.44 | $0.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $20.89 / $31.62
| Facility | | $2.45 | $20.89 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.44 / $0.44 / $0.62
| Facility | | $0.44 | $0.44 | $0.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.07 / $8.91
| Facility | | $1.07 | $1.07 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $1.29 / $1.29
| Professional | | $1.29 | $1.29 | $1.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.20 / $0.27 / $0.45
| Facility | | $0.20 | $0.27 | $0.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.20 / $0.27 / $0.45
| Professional | | $0.20 | $0.27 | $0.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.04 / $0.15 / $0.34
| Facility | | $0.04 | $0.15 | $0.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.40 / $0.71
| Professional | | $0.16 | $0.40 | $0.71 |