- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $1.95 / $223.87
| Facility | | $1.15 | $1.95 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $11.22 / $95.50
| Professional | | $1.29 | $11.22 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.44 / $0.87 / $2.69
| Facility | | $0.44 | $0.87 | $2.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.47 / $0.72
| Professional | | $0.41 | $0.47 | $0.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.98 / $0.98 / $0.98
| Facility | | $0.98 | $0.98 | $0.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.56 / $0.85
| Facility | | $0.56 | $0.56 | $0.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.56 / $1.32
| Professional | | $0.56 | $0.56 | $1.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.78 / $0.87 / $1.38
| Facility | | $0.78 | $0.87 | $1.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.41 / $0.89
| Professional | | $0.41 | $0.41 | $0.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.44 / $0.46 / $2.75
| Facility | | $0.44 | $0.46 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.46 / $0.46 / $0.89
| Professional | | $0.46 | $0.46 | $0.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.46 / $0.58 / $0.74
| Professional | | $0.46 | $0.58 | $0.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.39 / $0.50 / $0.83
| Professional | | $0.39 | $0.50 | $0.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.39 / $0.69 / $0.69
| Facility | | $0.39 | $0.69 | $0.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.32 / $0.46 / $0.52
| Professional | | $0.32 | $0.46 | $0.52 |