- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $5.62 / $9.12
| Facility | | $3.24 | $5.62 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.02 / $5.50
| Professional | | $2.00 | $3.02 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $4.27 / $7.41
| Facility | | $3.72 | $4.27 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $1.74 / $4.57
| Professional | | $1.23 | $1.74 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.51 / $4.57
| Facility | | $2.51 | $2.51 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $5.37
| Professional | | $5.37 | $5.37 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $4.79 / $15.85
| Facility | | $2.63 | $4.79 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $2.63 / $6.03
| Professional | | $1.66 | $2.63 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $2.63 / $13.80
| Facility | | $2.63 | $2.63 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $2.40 / $3.98
| Professional | | $1.58 | $2.40 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.63 / $5.01
| Professional | | $3.02 | $3.63 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $4.79 / $4.79
| Facility | | $4.79 | $4.79 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $4.17 / $8.13
| Professional | | $2.82 | $4.17 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $3.98 / $6.03
| Facility | | $1.70 | $3.98 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.02 / $3.98
| Professional | | $2.00 | $3.02 | $3.98 |