- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $7.94 / $37.15
| Facility | | $3.72 | $7.94 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.55 / $18.62
| Professional | | $3.02 | $3.55 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.75 / $2.75
| Professional | | $1.95 | $2.75 | $2.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.17 / $7.24
| Facility | | $3.63 | $4.17 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $2.34 / $3.24
| Professional | | $1.82 | $2.34 | $3.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $2.69
| Facility | | $2.69 | $2.69 | $2.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.16 / $3.16
| Professional | | $3.16 | $3.16 | $3.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $4.07 / $4.90
| Facility | | $2.63 | $4.07 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.89 / $5.25
| Professional | | $2.51 | $3.89 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $5.01 / $15.85
| Facility | | $2.57 | $5.01 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.72 / $7.41
| Professional | | $2.00 | $3.72 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $8.71 / $39.81
| Facility | | $2.51 | $8.71 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $2.63 / $7.41
| Professional | | $1.70 | $2.63 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $3.55 / $4.90
| Professional | | $2.95 | $3.55 | $4.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $4.68
| Facility | | $4.68 | $4.68 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $4.07 / $7.94
| Professional | | $2.75 | $4.07 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $3.89 / $5.89
| Facility | | $1.95 | $3.89 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $3.31 / $5.50
| Professional | | $2.34 | $3.31 | $5.50 |