- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $20.89 / $39.81
| Facility | | $5.25 | $20.89 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.98 / $9.77
| Professional | | $2.63 | $3.98 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $11.22 / $12.30
| Facility | | $6.92 | $11.22 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $4.79 / $7.59
| Professional | | $2.14 | $4.79 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $9.33 / $10.96
| Professional | | $8.91 | $9.33 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $24.55
| Facility | | $4.27 | $4.27 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.68 / $6.31
| Professional | | $3.98 | $4.68 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $8.51
| Facility | | $4.27 | $4.27 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $8.51
| Professional | | $4.27 | $4.27 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $5.89 / $12.59
| Facility | | $3.80 | $5.89 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.68 / $79.43
| Professional | | $3.80 | $4.68 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $12.59 / $17.38
| Facility | | $6.31 | $12.59 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.89 / $5.13
| Professional | | $3.16 | $3.89 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $5.13 / $6.76
| Facility | | $2.04 | $5.13 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.63 / $5.13
| Professional | | $2.51 | $2.63 | $5.13 |