- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $21.88 / $77.62
| Facility | | $5.37 | $21.88 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.37 / $33.88
| Professional | | $3.98 | $5.37 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $3.72
| Professional | | $3.31 | $3.31 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $7.94 / $10.72
| Facility | | $5.62 | $7.94 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.79 / $5.37
| Professional | | $4.07 | $4.79 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $12.02 / $19.50
| Facility | | $5.62 | $12.02 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $5.50 / $8.71
| Professional | | $3.24 | $5.50 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.79 / $64.57
| Professional | | $3.47 | $4.79 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $10.72
| Facility | | $5.37 | $5.37 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $4.79 / $5.37
| Professional | | $4.79 | $4.79 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $9.33 / $14.79
| Facility | | $5.37 | $9.33 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $4.79 / $6.46
| Professional | | $4.79 | $4.79 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $8.13 / $14.13
| Facility | | $6.17 | $8.13 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.79 / $5.37
| Professional | | $4.07 | $4.79 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $6.46 / $6.46
| Facility | | $4.79 | $6.46 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.16 / $6.92
| Professional | | $2.24 | $3.16 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $2.82 / $9.77
| Professional | | $2.45 | $2.82 | $9.77 |