- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $18.62 / $91.20
| Facility | | $2.45 | $18.62 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $2.04 / $8.32
| Professional | | $1.17 | $2.04 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $2.24 / $4.68
| Professional | | $1.35 | $2.24 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.34 / $4.17
| Facility | | $2.04 | $2.34 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.35 / $1.91
| Professional | | $1.07 | $1.35 | $1.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $1.51 / $2.24
| Facility | | $1.51 | $1.51 | $2.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.82 / $1.82
| Professional | | $1.82 | $1.82 | $1.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $2.34 / $2.82
| Facility | | $1.32 | $2.34 | $2.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $2.24 / $3.02
| Professional | | $1.45 | $2.24 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $2.95 / $8.51
| Facility | | $1.48 | $2.95 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $2.09 / $4.37
| Professional | | $1.15 | $2.09 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $14.79 / $39.81
| Facility | | $4.90 | $14.79 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.89 / $1.82 / $5.75
| Professional | | $0.89 | $1.82 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $2.04 / $2.75
| Professional | | $1.70 | $2.04 | $2.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $4.90
| Facility | | $2.69 | $2.69 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $2.51 / $4.90
| Professional | | $1.70 | $2.51 | $4.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $2.24 / $3.39
| Facility | | $1.12 | $2.24 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $2.24 / $3.47
| Professional | | $1.35 | $2.24 | $3.47 |