- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $9.12 / $39.81
| Facility | | $3.98 | $9.12 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.17 / $12.88
| Professional | | $3.02 | $4.17 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $2.00 / $5.37
| Professional | | $1.70 | $2.00 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.89 / $7.94
| Facility | | $3.98 | $5.89 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.63 / $3.98
| Professional | | $3.02 | $3.63 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.91 / $11.75
| Facility | | $4.07 | $8.91 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $4.17 / $5.89
| Professional | | $2.00 | $4.17 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.55 / $4.27
| Professional | | $2.57 | $3.55 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $7.94
| Facility | | $3.98 | $3.98 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $3.98
| Professional | | $3.98 | $3.98 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.46 / $10.96
| Facility | | $3.98 | $6.46 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $3.63 / $4.79
| Professional | | $3.63 | $3.63 | $4.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $6.03 / $10.72
| Facility | | $4.57 | $6.03 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.63 / $3.98
| Professional | | $3.02 | $3.63 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.79 / $4.79
| Facility | | $3.63 | $4.79 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $2.69 / $4.47
| Professional | | $2.40 | $2.69 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $2.09 / $7.24
| Professional | | $1.82 | $2.09 | $7.24 |