- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $7.94 / $9.77
| Facility | | $3.98 | $7.94 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.02 / $15.14
| Professional | | $2.00 | $3.02 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $9.55 / $9.77
| Facility | | $7.76 | $9.55 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $1.78 / $16.22
| Professional | | $1.78 | $1.78 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $2.40 / $2.40
| Facility | | $2.40 | $2.40 | $2.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $11.48 / $18.62
| Facility | | $10.00 | $11.48 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.37 / $11.22
| Professional | | $4.17 | $5.37 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $7.76 / $125.89
| Facility | | $1.91 | $7.76 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $3.24 / $79.43
| Facility | | $1.91 | $3.24 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $5.37 / $22.91
| Professional | | $2.14 | $5.37 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $32.36 / $64.57
| Professional | | $3.02 | $32.36 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $24.55
| Facility | | $4.27 | $4.27 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $5.89 / $30.90
| Professional | | $2.69 | $5.89 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $9.33 / $15.14
| Professional | | $4.90 | $9.33 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $79.43
| Facility | | $7.08 | $7.08 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $1.91 / $10.47
| Professional | | $1.91 | $1.91 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $16.22
| Professional | | $7.59 | $7.59 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $19.50 / $63.10
| Professional | | $16.22 | $19.50 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $3.16 / $8.71
| Facility | | $1.78 | $3.16 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $3.55 / $22.91
| Professional | | $1.51 | $3.55 | $22.91 |