- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $3.80
| Facility | | $3.02 | $3.02 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.02 / $3.98
| Professional | | $2.00 | $3.02 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $5.01 / $5.13
| Professional | | $2.88 | $5.01 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $15.14 / $28.84
| Facility | | $6.61 | $15.14 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $5.25
| Professional | | $5.01 | $5.01 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $6.03 / $10.72
| Facility | | $2.88 | $6.03 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.08 / $7.08
| Professional | | $5.01 | $7.08 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $3.16
| Facility | | $3.02 | $3.02 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.51 / $3.72
| Professional | | $2.51 | $2.51 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.16 / $10.47
| Facility | | $2.82 | $3.16 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.98 / $6.17
| Professional | | $2.51 | $3.98 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $3.16
| Facility | | $3.02 | $3.02 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.51 / $3.72
| Professional | | $2.51 | $2.51 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.95 / $3.16
| Facility | | $1.38 | $1.95 | $3.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $2.34 / $3.55
| Professional | | $1.66 | $2.34 | $3.55 |