- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $10.00 / $25.12
| Facility | | $4.47 | $10.00 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $9.77
| Professional | | $3.98 | $3.98 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $8.32 / $25.12
| Facility | | $4.17 | $8.32 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.57 / $7.76
| Professional | | $3.89 | $4.57 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $5.25
| Facility | | $5.25 | $5.25 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $2.24 / $2.24
| Facility | | $2.24 | $2.24 | $2.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $3.02
| Professional | | $3.02 | $3.02 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $8.13 / $12.88
| Facility | | $7.24 | $8.13 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $3.89 / $4.90
| Professional | | $3.89 | $3.89 | $4.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.47 / $23.44
| Facility | | $4.27 | $4.47 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.47 / $14.45
| Professional | | $4.47 | $4.47 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.24 / $6.31
| Professional | | $2.24 | $3.24 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $6.46 / $8.91
| Professional | | $3.63 | $6.46 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $7.76 / $7.76
| Facility | | $4.37 | $7.76 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $4.47 / $5.13
| Professional | | $3.55 | $4.47 | $5.13 |