- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $12.59 / $70.79
| Facility | | $5.75 | $12.59 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.37 / $14.45
| Professional | | $3.98 | $5.37 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.17 / $9.33
| Professional | | $3.02 | $4.17 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $6.31 / $11.22
| Facility | | $5.50 | $6.31 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $3.63 / $7.59
| Professional | | $2.95 | $3.63 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.07 / $4.07
| Facility | | $4.07 | $4.07 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $6.31 / $7.59
| Facility | | $4.07 | $6.31 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $6.03 / $8.13
| Professional | | $3.89 | $6.03 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $7.76 / $24.55
| Facility | | $3.98 | $7.76 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.89 / $11.75
| Professional | | $3.16 | $3.89 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $12.88 / $67.61
| Facility | | $3.89 | $12.88 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $4.79 / $9.77
| Professional | | $2.40 | $4.79 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $5.37 / $7.41
| Professional | | $4.47 | $5.37 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $7.24
| Facility | | $7.24 | $7.24 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $6.31 / $12.30
| Professional | | $4.27 | $6.31 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $6.03 / $9.12
| Facility | | $3.02 | $6.03 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.63 / $7.94
| Professional | | $2.51 | $3.63 | $7.94 |