- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $19.95 / $48.98
| Facility | | $3.47 | $19.95 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.14 / $3.55
| Professional | | $1.86 | $2.14 | $3.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $6.31 / $8.51
| Facility | | $3.89 | $6.31 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $2.57 / $4.27
| Professional | | $1.66 | $2.57 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.01 / $6.03
| Professional | | $4.79 | $5.01 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $4.47 / $43.65
| Facility | | $2.34 | $4.47 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.95 / $4.17
| Professional | | $2.14 | $2.95 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.34 / $4.57
| Facility | | $2.34 | $2.34 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.34 / $2.75
| Professional | | $2.34 | $2.34 | $2.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $3.39 / $7.24
| Facility | | $2.29 | $3.39 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.95 / $79.43
| Professional | | $2.34 | $2.95 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $7.08 / $9.77
| Facility | | $3.55 | $7.08 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $2.40 / $3.02
| Professional | | $1.78 | $2.40 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $2.82 / $3.80
| Facility | | $1.48 | $2.82 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.95 / $3.31
| Professional | | $1.41 | $1.95 | $3.31 |