- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.01 / $5.01
| Facility | | $3.02 | $5.01 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.24 / $5.01
| Professional | | $2.00 | $3.24 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $3.63 / $6.76
| Facility | | $3.63 | $3.63 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $7.08 / $8.91
| Professional | | $3.89 | $7.08 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.03 / $10.00
| Professional | | $5.75 | $6.03 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $6.76 / $79.43
| Facility | | $4.17 | $6.76 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.72 / $8.91
| Professional | | $2.57 | $3.72 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $6.92 / $7.94
| Professional | | $6.61 | $6.92 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $6.76
| Facility | | $6.76 | $6.76 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $10.23 / $10.23
| Professional | | $5.25 | $10.23 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $2.57 / $4.27
| Facility | | $1.74 | $2.57 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $3.02 / $5.62
| Professional | | $2.34 | $3.02 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.50 / $5.50
| Professional | | $4.37 | $5.50 | $5.50 |