- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $18.20 / $43.65
| Facility | | $4.37 | $18.20 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.01 / $20.89
| Professional | | $3.02 | $5.01 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $2.19 / $4.37
| Professional | | $1.78 | $2.19 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.46 / $8.71
| Facility | | $4.37 | $6.46 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.98 / $4.37
| Professional | | $3.31 | $3.98 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $9.77 / $12.88
| Facility | | $4.17 | $9.77 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $4.47 / $6.46
| Professional | | $2.19 | $4.47 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.89 / $4.68
| Professional | | $2.82 | $3.89 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $8.71
| Facility | | $4.37 | $4.37 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $8.71
| Professional | | $4.37 | $4.37 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $7.08 / $12.02
| Facility | | $4.37 | $7.08 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $5.25
| Professional | | $3.98 | $3.98 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.61 / $11.48
| Facility | | $5.01 | $6.61 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.98 / $4.37
| Professional | | $3.31 | $3.98 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.25 / $5.25
| Facility | | $3.98 | $5.25 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $2.82 / $4.90
| Professional | | $2.63 | $2.82 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $2.29 / $3.02
| Professional | | $2.29 | $2.29 | $3.02 |