- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $6.92 / $10.72
| Facility | | $3.63 | $6.92 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $7.08
| Professional | | $3.02 | $3.98 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.79 / $8.32
| Facility | | $4.17 | $4.79 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $2.82 / $5.89
| Professional | | $2.24 | $2.82 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.09 / $5.25
| Facility | | $3.09 | $3.09 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $6.17
| Professional | | $6.17 | $6.17 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.89 / $18.62
| Facility | | $3.02 | $5.89 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $3.02 / $8.71
| Professional | | $2.29 | $3.02 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $2.95 / $17.38
| Facility | | $2.95 | $2.95 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $2.95 / $6.31
| Professional | | $2.29 | $2.95 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $4.07 / $5.62
| Professional | | $3.39 | $4.07 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $5.50
| Facility | | $5.50 | $5.50 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $4.79 / $9.33
| Professional | | $3.16 | $4.79 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $4.57 / $6.92
| Facility | | $2.29 | $4.57 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $2.75 / $5.50
| Professional | | $1.91 | $2.75 | $5.50 |