- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $17.78 / $74.13
| Facility | | $4.37 | $17.78 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.63 / $10.00
| Professional | | $2.00 | $3.63 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.19 / $2.19
| Professional | | $1.86 | $2.19 | $2.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.37 / $5.13
| Facility | | $3.89 | $4.37 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.37 / $6.17
| Professional | | $3.47 | $4.37 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.98 / $18.20
| Facility | | $2.69 | $3.98 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $3.72 / $6.76
| Professional | | $2.14 | $3.72 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $10.96 / $23.99
| Facility | | $3.24 | $10.96 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $2.63 / $4.57
| Professional | | $2.63 | $2.63 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.09 / $2.63
| Professional | | $2.09 | $2.09 | $2.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $2.63 / $4.37
| Facility | | $1.82 | $2.63 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.69 / $4.57
| Professional | | $1.95 | $2.69 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $2.63 / $4.07
| Professional | | $2.63 | $2.63 | $4.07 |