- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $37.15 / $87.10
| Facility | | $4.68 | $37.15 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.55 / $8.71
| Professional | | $3.02 | $3.55 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $6.92 / $8.13
| Professional | | $2.14 | $6.92 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.31 / $8.51
| Facility | | $4.37 | $6.31 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.89 / $4.27
| Professional | | $3.24 | $3.89 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $9.55 / $14.13
| Facility | | $4.47 | $9.55 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $4.47 / $6.46
| Professional | | $2.34 | $4.47 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.80 / $4.57
| Professional | | $2.75 | $3.80 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $8.51
| Facility | | $4.27 | $4.27 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $4.27
| Professional | | $4.27 | $4.27 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $7.59 / $11.75
| Facility | | $4.27 | $7.59 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $3.89 / $5.13
| Professional | | $3.89 | $3.89 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $6.46 / $11.48
| Facility | | $4.90 | $6.46 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.89 / $4.27
| Professional | | $3.24 | $3.89 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.13 / $5.13
| Facility | | $3.89 | $5.13 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.31 / $5.50
| Professional | | $2.57 | $3.31 | $5.50 |