- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $7.76 / $33.11
| Facility | | $3.47 | $7.76 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.02 / $5.13
| Professional | | $2.00 | $3.02 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.09 / $2.09
| Professional | | $2.09 | $2.09 | $2.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $5.13 / $6.92
| Facility | | $3.63 | $5.13 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.09 / $3.47
| Professional | | $2.57 | $3.09 | $3.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $7.59 / $10.96
| Facility | | $3.55 | $7.59 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $3.47 / $5.62
| Professional | | $2.04 | $3.47 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.02 / $64.57
| Professional | | $2.19 | $3.02 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $6.76
| Facility | | $3.47 | $3.47 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $6.76
| Professional | | $3.47 | $3.47 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $6.03 / $9.33
| Facility | | $3.47 | $6.03 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.09 / $4.07
| Professional | | $3.09 | $3.09 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.13 / $9.12
| Facility | | $3.98 | $5.13 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.09 / $3.47
| Professional | | $2.57 | $3.09 | $3.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.07 / $4.07
| Facility | | $3.09 | $4.07 | $4.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $2.04 / $4.37
| Professional | | $1.45 | $2.04 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $1.78 / $6.17
| Professional | | $1.55 | $1.78 | $6.17 |