- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $3.98
| Facility | | $3.02 | $3.98 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.02 / $5.01
| Professional | | $2.00 | $3.02 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $6.31
| Professional | | $3.02 | $3.02 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.07 / $4.27
| Professional | | $4.07 | $4.07 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $3.63 / $3.89
| Facility | | $3.63 | $3.63 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.09 / $3.63
| Professional | | $3.09 | $3.09 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.17 / $8.71
| Professional | | $4.68 | $6.17 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.37 / $6.61
| Professional | | $3.02 | $4.37 | $6.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $4.47 / $7.59
| Facility | | $2.57 | $4.47 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $3.80 / $4.07
| Professional | | $3.39 | $3.80 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.50 / $21.38
| Facility | | $4.17 | $5.50 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.37 / $17.78
| Professional | | $4.17 | $5.37 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $2.34 / $3.09
| Facility | | $1.74 | $2.34 | $3.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.02 / $4.79
| Professional | | $2.69 | $3.02 | $4.79 |