- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $23.44 / $91.20
| Facility | | $3.98 | $23.44 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.02 / $26.30
| Professional | | $2.82 | $3.02 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.51 / $2.51
| Professional | | $2.51 | $2.51 | $2.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.89 / $7.94
| Facility | | $4.07 | $5.89 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.63 / $3.98
| Professional | | $3.02 | $3.63 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $8.91 / $13.18
| Facility | | $4.17 | $8.91 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $4.17 / $6.03
| Professional | | $2.34 | $4.17 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.55 / $4.27
| Professional | | $2.57 | $3.55 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $7.94
| Facility | | $3.98 | $3.98 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $3.98
| Professional | | $3.98 | $3.98 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $7.08 / $10.96
| Facility | | $3.98 | $7.08 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $3.63 / $4.79
| Professional | | $3.63 | $3.63 | $4.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $6.03 / $10.72
| Facility | | $4.57 | $6.03 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.63 / $3.98
| Professional | | $3.02 | $3.63 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.79 / $4.79
| Facility | | $3.63 | $4.79 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $2.14 / $4.68
| Professional | | $1.70 | $2.14 | $4.68 |