- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $17.78 / $83.18
| Facility | | $3.98 | $17.78 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $6.61
| Professional | | $3.02 | $3.98 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.02 / $3.09
| Professional | | $2.82 | $3.02 | $3.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $5.13 / $6.03
| Facility | | $4.47 | $5.13 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.13 / $6.92
| Professional | | $4.27 | $5.13 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $5.75 / $13.18
| Facility | | $3.31 | $5.75 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $5.13 / $9.77
| Professional | | $2.63 | $5.13 | $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
- $3.02 / $3.02 / $6.61
| Professional | | $3.02 | $3.02 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $2.45 / $3.02
| Professional | | $2.45 | $2.45 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $3.89 / $5.89
| Facility | | $2.14 | $3.89 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.82 / $6.61
| Professional | | $2.04 | $2.82 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $5.13
| Professional | | $3.02 | $3.02 | $5.13 |