- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $19.05 / $66.07
| Facility | | $4.68 | $19.05 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.89 / $6.61
| Professional | | $3.31 | $3.89 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $2.88 / $3.02
| Professional | | $2.88 | $2.88 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $7.08 / $9.55
| Facility | | $4.79 | $7.08 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $4.27 / $4.68
| Professional | | $3.55 | $4.27 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $10.47 / $15.49
| Facility | | $4.90 | $10.47 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $4.79 / $7.24
| Professional | | $2.75 | $4.79 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.17 / $64.57
| Professional | | $3.02 | $4.17 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $9.33
| Facility | | $4.68 | $4.68 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $5.25
| Professional | | $4.68 | $4.68 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $8.32 / $12.88
| Facility | | $4.68 | $8.32 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $5.62
| Professional | | $4.27 | $4.27 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $7.08 / $12.59
| Facility | | $5.50 | $7.08 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $4.27 / $4.68
| Professional | | $3.55 | $4.27 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.62 / $5.62
| Facility | | $4.27 | $5.62 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.51 / $5.62
| Professional | | $2.00 | $2.51 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.45 / $8.51
| Professional | | $2.14 | $2.45 | $8.51 |