- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $51.29 / $144.54
| Facility | | $5.01 | $51.29 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.34 / $8.51
| Professional | | $2.00 | $2.34 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $1.62 / $1.86
| Professional | | $1.62 | $1.62 | $1.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $2.69 / $3.16
| Facility | | $2.40 | $2.69 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $2.69 / $3.98
| Professional | | $2.24 | $2.69 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $3.31 / $6.92
| Facility | | $1.86 | $3.31 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $2.82 / $5.01
| Professional | | $1.45 | $2.82 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $11.48 / $25.70
| Facility | | $2.69 | $11.48 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $1.62 / $3.80
| Professional | | $1.62 | $1.62 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $1.41 / $1.78
| Professional | | $1.29 | $1.41 | $1.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $2.19 / $3.31
| Facility | | $1.12 | $2.19 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.58 / $3.80
| Professional | | $1.12 | $1.58 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $1.78 / $2.69
| Professional | | $1.78 | $1.78 | $2.69 |