- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $21.38 / $79.43
| Facility | | $5.25 | $21.38 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $16.22
| Professional | | $3.98 | $5.01 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $3.39
| Professional | | $3.31 | $3.31 | $3.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $5.62 / $6.61
| Facility | | $4.90 | $5.62 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.62 / $8.13
| Professional | | $4.57 | $5.62 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $6.76 / $14.45
| Facility | | $3.89 | $6.76 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $5.75 / $10.96
| Professional | | $2.95 | $5.75 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $23.44 / $51.29
| Facility | | $5.62 | $23.44 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $7.76
| Professional | | $3.31 | $3.31 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $3.31
| Professional | | $2.69 | $2.69 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $4.57 / $6.92
| Facility | | $2.34 | $4.57 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $3.31 / $7.76
| Professional | | $2.09 | $3.31 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $5.62
| Professional | | $3.31 | $3.31 | $5.62 |