- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $16.22 / $44.67
| Facility | | $5.25 | $16.22 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $6.92
| Professional | | $3.02 | $3.98 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $3.09 / $4.37
| Professional | | $1.86 | $3.09 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $6.46 / $8.71
| Facility | | $4.57 | $6.46 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.98 / $4.37
| Professional | | $3.31 | $3.98 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $9.77 / $14.45
| Facility | | $4.57 | $9.77 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $4.47 / $7.08
| Professional | | $2.63 | $4.47 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.89 / $4.68
| Professional | | $2.82 | $3.89 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $8.71
| Facility | | $4.37 | $4.37 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $4.37
| Professional | | $4.37 | $4.37 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $7.76 / $12.02
| Facility | | $4.37 | $7.76 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $5.25
| Professional | | $3.98 | $3.98 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.61 / $11.75
| Facility | | $5.01 | $6.61 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.98 / $4.37
| Professional | | $3.31 | $3.98 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.25 / $5.25
| Facility | | $3.98 | $5.25 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.57 / $5.62
| Professional | | $1.86 | $2.57 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.29 / $7.94
| Professional | | $2.00 | $2.29 | $7.94 |