- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $2.14 / $60.26
| Facility | | $1.23 | $2.14 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.87 / $1.26 / $1.26
| Professional | | $0.87 | $1.26 | $1.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.27 / $0.30 / $0.40
| Facility | | $0.27 | $0.30 | $0.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $0.28 / $0.56
| Professional | | $0.26 | $0.28 | $0.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.33 / $0.35 / $0.66
| Facility | | $0.33 | $0.35 | $0.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $0.34 / $0.56
| Professional | | $0.26 | $0.34 | $0.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.46 / $0.62
| Facility | | $0.28 | $0.46 | $0.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $0.26 / $0.31
| Professional | | $0.26 | $0.26 | $0.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.24 / $0.33
| Professional | | $0.15 | $0.24 | $0.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.23 / $0.28 / $0.46
| Professional | | $0.23 | $0.28 | $0.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $478.63 / $478.63
| Professional | | $478.63 | $478.63 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.28 / $0.28
| Professional | | $0.28 | $0.28 | $0.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $0.28 / $0.52
| Facility | | $0.26 | $0.28 | $0.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $0.26 / $0.36
| Professional | | $0.26 | $0.26 | $0.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.55 / $0.55 / $0.55
| Professional | | $0.55 | $0.55 | $0.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.21 / $0.28
| Professional | | $0.15 | $0.21 | $0.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.83 / $0.83 / $0.83
| Facility | | $0.83 | $0.83 | $0.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $0.26 / $0.47
| Professional | | $0.26 | $0.26 | $0.47 |