- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $22.91 / $91.20
| Facility | | $3.98 | $22.91 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.02 / $34.67
| Professional | | $2.00 | $3.02 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $2.09 / $3.47
| Professional | | $1.58 | $2.09 | $3.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $3.31 / $5.89
| Facility | | $2.88 | $3.31 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $4.07 / $6.46
| Professional | | $2.19 | $4.07 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.14 / $2.14
| Facility | | $2.14 | $2.14 | $2.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.51 / $2.51
| Professional | | $2.51 | $2.51 | $2.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.31 / $3.98
| Facility | | $3.16 | $3.31 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $3.16 / $4.27
| Professional | | $2.04 | $3.16 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $4.07 / $12.88
| Facility | | $2.14 | $4.07 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $3.16 / $6.03
| Professional | | $1.66 | $3.16 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $21.38 / $63.10
| Facility | | $7.08 | $21.38 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $2.51 / $5.75
| Professional | | $1.26 | $2.51 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $2.82 / $3.89
| Professional | | $2.40 | $2.82 | $3.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $5.62
| Facility | | $3.80 | $3.80 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $3.47 / $6.46
| Professional | | $2.40 | $3.47 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $3.16 / $4.79
| Facility | | $1.32 | $3.16 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $3.16 / $34.67
| Professional | | $1.91 | $3.16 | $34.67 |