- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $4.68 / $9.33
| Facility | | $3.55 | $4.68 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $6.03
| Professional | | $3.02 | $3.02 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $3.55 / $3.63
| Facility | | $3.55 | $3.55 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $3.55 / $3.55
| Professional | | $3.55 | $3.55 | $3.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.09 / $3.24
| Facility | | $3.09 | $3.09 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.09 / $3.09
| Professional | | $3.09 | $3.09 | $3.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $4.68 / $5.25
| Facility | | $3.39 | $4.68 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $3.55 / $14.79
| Professional | | $3.55 | $3.55 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $4.27 / $12.02
| Facility | | $3.31 | $4.27 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $4.37
| Professional | | $3.80 | $3.80 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $3.72
| Facility | | $3.47 | $3.47 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $3.63
| Professional | | $3.47 | $3.47 | $3.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $50,118.72 / $75,857.76
| Facility | | $4.57 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $3.55 / $5.89
| Facility | | $3.55 | $3.55 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $3.72 / $7.59
| Professional | | $3.55 | $3.72 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $4.17
| Facility | | $3.47 | $3.47 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.63 / $4.17
| Professional | | $3.47 | $3.63 | $4.17 |