- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $17.38 / $48.98
| Facility | | $3.55 | $17.38 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.47 / $6.76
| Professional | | $3.02 | $4.47 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.47 / $3.55
| Professional | | $3.09 | $3.47 | $3.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.75 / $6.76
| Facility | | $5.13 | $5.75 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.75 / $6.76
| Professional | | $4.79 | $5.75 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $5.75 / $14.79
| Facility | | $3.80 | $5.75 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.62 / $10.47
| Professional | | $3.02 | $5.62 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $19.50 / $42.66
| Facility | | $4.68 | $19.50 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $6.46
| Professional | | $3.47 | $3.47 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $2.75 / $3.47
| Professional | | $2.75 | $2.75 | $3.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $4.27 / $6.46
| Facility | | $2.45 | $4.27 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $2.88 / $7.24
| Professional | | $2.24 | $2.88 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $5.75
| Professional | | $3.47 | $3.47 | $5.75 |