- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $26.92 / $72.44
| Facility | | $4.47 | $26.92 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.45 / $6.92
| Professional | | $2.00 | $2.45 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $7.08 / $9.77
| Facility | | $4.37 | $7.08 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $2.95 / $4.90
| Professional | | $1.82 | $2.95 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.75 / $6.76
| Professional | | $5.50 | $5.75 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $8.71 / $60.26
| Facility | | $2.69 | $8.71 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $3.24 / $6.92
| Professional | | $2.34 | $3.24 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $5.25
| Facility | | $2.69 | $2.69 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $3.80
| Professional | | $2.69 | $2.69 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.89 / $7.94
| Facility | | $2.63 | $3.89 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.39 / $79.43
| Professional | | $2.69 | $3.39 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.13 / $11.22
| Facility | | $4.07 | $8.13 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.75 / $3.47
| Professional | | $2.04 | $2.75 | $3.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $3.24 / $4.37
| Facility | | $1.70 | $3.24 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.55 / $3.80
| Professional | | $1.12 | $1.55 | $3.80 |