- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $12.59 / $20.42
| Facility | | $6.61 | $12.59 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.92 / $12.59
| Professional | | $6.03 | $6.92 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $8.71 / $15.14
| Facility | | $7.59 | $8.71 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.13 / $10.47
| Professional | | $4.07 | $5.13 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $6.61 / $9.33
| Facility | | $6.61 | $6.61 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $10.96
| Professional | | $10.96 | $10.96 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $10.72 / $33.11
| Facility | | $5.37 | $10.72 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.37 / $15.49
| Professional | | $4.17 | $5.37 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $30.90
| Facility | | $5.37 | $5.37 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.25 / $11.48
| Professional | | $4.17 | $5.25 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $7.59 / $10.23
| Professional | | $6.17 | $7.59 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $9.77
| Facility | | $9.77 | $9.77 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $8.51 / $16.60
| Professional | | $5.75 | $8.51 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.13 / $12.30
| Facility | | $4.07 | $8.13 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.90 / $9.77
| Professional | | $3.47 | $4.90 | $9.77 |