- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $9.33 / $28.84
| Facility | | $3.63 | $9.33 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.02 / $9.12
| Professional | | $2.00 | $3.02 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.17 / $7.24
| Facility | | $3.63 | $4.17 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.40 / $5.13
| Professional | | $1.95 | $2.40 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $2.63 / $4.57
| Facility | | $2.63 | $2.63 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $5.37
| Professional | | $5.37 | $5.37 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $5.13 / $25.12
| Facility | | $2.57 | $5.13 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.51 / $7.41
| Professional | | $2.00 | $2.51 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $4.07 / $15.85
| Facility | | $2.57 | $4.07 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.51 / $5.50
| Professional | | $2.00 | $2.51 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $3.72 / $4.90
| Professional | | $2.95 | $3.72 | $4.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $4.68
| Facility | | $4.68 | $4.68 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $4.17 / $7.94
| Professional | | $2.75 | $4.17 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $3.98 / $5.89
| Facility | | $1.95 | $3.98 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $2.34 / $4.68
| Professional | | $1.66 | $2.34 | $4.68 |