- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $9.77 / $53.70
| Facility | | $2.51 | $9.77 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.00 / $3.02
| Professional | | $1.00 | $2.00 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $1.51 / $1.55
| Professional | | $1.51 | $1.51 | $1.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $2.51 / $3.02
| Facility | | $2.24 | $2.51 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.51 / $3.72
| Professional | | $2.09 | $2.51 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $3.09 / $6.46
| Facility | | $1.78 | $3.09 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $2.63 / $5.13
| Professional | | $1.35 | $2.63 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $10.96 / $23.99
| Facility | | $2.51 | $10.96 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $1.51 / $3.55
| Professional | | $1.51 | $1.51 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $1.23 / $1.51
| Professional | | $1.23 | $1.23 | $1.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $2.09 / $3.16
| Facility | | $1.07 | $2.09 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.48 / $3.55
| Professional | | $1.07 | $1.48 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $1.51 / $2.51
| Professional | | $1.51 | $1.51 | $2.51 |