- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $144.54 / $380.19
| Facility | | $1.17 | $144.54 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $11.22 / $21.88
| Professional | | $1.29 | $11.22 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.87 / $1.38
| Facility | | $0.41 | $0.87 | $1.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.41 / $0.85
| Professional | | $0.41 | $0.41 | $0.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.47 / $0.47
| Professional | | $0.41 | $0.47 | $0.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.78 / $1.02
| Facility | | $0.43 | $0.78 | $1.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.41 / $0.41
| Professional | | $0.41 | $0.41 | $0.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.41 / $3.39
| Professional | | $0.35 | $0.41 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.37 / $5.62
| Professional | | $4.07 | $4.37 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.46 / $0.72 / $5.62
| Facility | | $0.46 | $0.72 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.78 / $0.78 / $1.17
| Professional | | $0.78 | $0.78 | $1.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.39 / $0.54 / $0.85
| Facility | | $0.39 | $0.54 | $0.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.39 / $0.54 / $0.85
| Professional | | $0.39 | $0.54 | $0.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.52 / $0.69
| Facility | | $0.52 | $0.52 | $0.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.34 / $0.49 / $0.54
| Professional | | $0.34 | $0.49 | $0.54 |