- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $36.31 / $91.20
| Facility | | $3.24 | $36.31 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.09 / $5.75
| Professional | | $1.00 | $2.09 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $1.45 / $1.62
| Professional | | $1.20 | $1.45 | $1.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.34 / $2.82
| Facility | | $2.09 | $2.34 | $2.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $2.34 / $3.47
| Professional | | $1.91 | $2.34 | $3.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $2.63 / $6.03
| Facility | | $1.62 | $2.63 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $2.34 / $4.57
| Professional | | $1.48 | $2.34 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $10.23 / $22.39
| Facility | | $2.34 | $10.23 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $3.31 / $4.68
| Professional | | $1.20 | $3.31 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.12 / $1.41
| Professional | | $1.12 | $1.12 | $1.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.09 / $2.95
| Facility | | $1.00 | $2.09 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.95 / $3.31
| Professional | | $1.07 | $1.95 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.41 / $1.41
| Professional | | $1.41 | $1.41 | $1.41 |