- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $10.96 / $52.48
| Facility | | $3.16 | $10.96 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.02 / $5.01
| Professional | | $2.00 | $3.02 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.04 / $2.09
| Professional | | $2.04 | $2.04 | $2.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.47 / $4.07
| Facility | | $3.02 | $3.47 | $4.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.47 / $5.01
| Professional | | $2.82 | $3.47 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $4.17 / $14.45
| Facility | | $2.40 | $4.17 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $3.63 / $6.76
| Professional | | $1.91 | $3.63 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $14.79 / $32.36
| Facility | | $3.47 | $14.79 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.04 / $4.79
| Professional | | $2.04 | $2.04 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $1.66 / $2.04
| Professional | | $1.66 | $1.66 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $2.82 / $4.27
| Facility | | $1.45 | $2.82 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $2.04 / $4.79
| Professional | | $1.45 | $2.04 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.04 / $3.47
| Professional | | $2.04 | $2.04 | $3.47 |