- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $10.72 / $77.62
| Facility | | $1.82 | $10.72 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $6.76
| Professional | | $3.02 | $3.98 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.16 / $3.16
| Professional | | $3.09 | $3.16 | $3.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $5.13 / $6.03
| Facility | | $4.47 | $5.13 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.13 / $7.41
| Professional | | $4.27 | $5.13 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $6.17 / $13.18
| Facility | | $3.55 | $6.17 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $5.37 / $10.47
| Professional | | $2.69 | $5.37 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $21.88 / $47.86
| Facility | | $5.13 | $21.88 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.09 / $7.08
| Professional | | $3.09 | $3.09 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $2.45 / $3.09
| Professional | | $2.45 | $2.45 | $3.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $4.17 / $6.31
| Facility | | $2.14 | $4.17 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $3.02 / $7.08
| Professional | | $2.09 | $3.02 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.09 / $5.13
| Professional | | $3.09 | $3.09 | $5.13 |