- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $22.91 / $63.10
| Facility | | $5.13 | $22.91 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.27 / $26.30
| Professional | | $3.02 | $4.27 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $3.31 / $4.79
| Professional | | $1.91 | $3.31 | $4.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.01 / $8.71
| Facility | | $4.37 | $5.01 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.88 / $6.17
| Professional | | $2.34 | $2.88 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.24 / $3.24
| Facility | | $3.24 | $3.24 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.80 / $3.80
| Professional | | $3.31 | $3.80 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.01 / $5.89
| Facility | | $4.79 | $5.01 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.79 / $6.46
| Professional | | $3.09 | $4.79 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $6.17 / $19.95
| Facility | | $3.09 | $6.17 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $3.09 / $9.12
| Professional | | $2.45 | $3.09 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $22.91 / $51.29
| Facility | | $6.46 | $22.91 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $3.80 / $14.13
| Professional | | $1.91 | $3.80 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $4.27 / $5.89
| Professional | | $3.55 | $4.27 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $5.75
| Facility | | $5.75 | $5.75 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $5.25 / $10.47
| Professional | | $3.31 | $5.25 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $4.79 / $7.08
| Facility | | $2.09 | $4.79 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.82 / $6.61
| Professional | | $2.00 | $2.82 | $6.61 |