- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $22.39 / $83.18
| Facility | | $4.47 | $22.39 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.01 / $18.20
| Professional | | $3.02 | $5.01 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $3.47 / $3.98
| Professional | | $2.88 | $3.47 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.75 / $6.76
| Facility | | $5.13 | $5.75 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $5.75 / $5.75
| Professional | | $2.57 | $5.75 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.46 / $14.79
| Facility | | $3.98 | $6.46 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $6.03 / $11.75
| Professional | | $3.09 | $6.03 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $7.41 / $16.22
| Facility | | $1.74 | $7.41 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $2.88 / $4.68
| Professional | | $1.45 | $2.88 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.14 / $2.63
| Professional | | $1.95 | $2.14 | $2.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $4.68 / $7.08
| Facility | | $2.45 | $4.68 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.51 / $8.13
| Professional | | $1.00 | $2.51 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $2.40 / $2.40
| Professional | | $2.40 | $2.40 | $2.40 |