- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $13.80 / $45.71
| Facility | | $3.63 | $13.80 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.75 / $18.62
| Professional | | $2.00 | $2.75 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $7.94 / $10.96
| Facility | | $4.90 | $7.94 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $3.31 / $5.50
| Professional | | $2.14 | $3.31 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.46 / $7.59
| Professional | | $6.17 | $6.46 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $33.11
| Facility | | $3.02 | $3.02 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.63 / $5.50
| Professional | | $3.02 | $3.63 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $5.89
| Facility | | $3.02 | $3.02 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $3.63
| Professional | | $3.02 | $3.02 | $3.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $4.27 / $9.33
| Facility | | $2.95 | $4.27 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.63 / $79.43
| Professional | | $3.02 | $3.63 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $9.12 / $12.59
| Facility | | $4.57 | $9.12 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $3.09 / $3.89
| Professional | | $2.29 | $3.09 | $3.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $3.63 / $4.90
| Facility | | $1.91 | $3.63 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $2.45 / $4.27
| Professional | | $1.82 | $2.45 | $4.27 |