- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $14.13 / $72.44
| Facility | | $2.69 | $14.13 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.45 / $7.59
| Professional | | $2.00 | $2.45 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $1.86 / $5.01
| Professional | | $1.66 | $1.86 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.98 / $5.37
| Facility | | $2.82 | $3.98 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.45 / $2.69
| Professional | | $2.04 | $2.45 | $2.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $6.03 / $9.77
| Facility | | $2.82 | $6.03 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $2.75 / $4.07
| Professional | | $1.62 | $2.75 | $4.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $2.34 / $2.88
| Professional | | $1.74 | $2.34 | $2.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $5.37
| Facility | | $2.69 | $2.69 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.90 / $4.90
| Professional | | $3.24 | $4.90 | $4.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.68 / $7.41
| Facility | | $2.69 | $4.68 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $2.45 / $3.24
| Professional | | $2.45 | $2.45 | $3.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.07 / $7.08
| Facility | | $3.09 | $4.07 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.45 / $2.69
| Professional | | $2.04 | $2.45 | $2.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $3.24 / $3.24
| Facility | | $2.45 | $3.24 | $3.24 |
- 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
- $1.23 / $1.41 / $4.90
| Professional | | $1.23 | $1.41 | $4.90 |