- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $14.79 / $56.23
| Facility | | $3.89 | $14.79 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $4.27 / $18.20
| Professional | | $2.63 | $4.27 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $8.51 / $9.55
| Facility | | $5.37 | $8.51 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $3.55 / $5.50
| Professional | | $1.58 | $3.55 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $7.24 / $8.51
| Professional | | $6.76 | $7.24 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $33.11
| Facility | | $3.31 | $3.31 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.63 / $5.75
| Professional | | $2.57 | $3.63 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $6.61
| Facility | | $3.31 | $3.31 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $3.98
| Professional | | $3.31 | $3.31 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $4.57 / $9.77
| Facility | | $2.29 | $4.57 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $3.63 / $79.43
| Professional | | $2.45 | $3.63 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $9.77 / $12.88
| Facility | | $4.90 | $9.77 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.45 / $3.98
| Professional | | $1.86 | $2.45 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $3.98 / $5.25
| Facility | | $1.48 | $3.98 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $1.95 / $3.98
| Professional | | $1.91 | $1.95 | $3.98 |