- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $18.20 / $120.23
| Facility | | $4.79 | $18.20 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $6.03
| Professional | | $3.02 | $3.98 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $3.39
| Professional | | $3.02 | $3.02 | $3.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $5.62 / $6.61
| Facility | | $4.90 | $5.62 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.62 / $6.92
| Professional | | $4.57 | $5.62 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $5.75 / $14.13
| Facility | | $3.63 | $5.75 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $5.25 / $9.77
| Professional | | $2.82 | $5.25 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $20.42 / $44.67
| Facility | | $4.68 | $20.42 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $6.61
| Professional | | $3.31 | $3.31 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $3.31
| Professional | | $2.69 | $2.69 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $3.89 / $5.89
| Facility | | $2.34 | $3.89 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $2.82 / $6.61
| Professional | | $2.29 | $2.82 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $5.62
| Professional | | $3.31 | $3.31 | $5.62 |