- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.46 / $12.88
| Facility | | $4.47 | $6.46 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $6.03
| Professional | | $3.98 | $3.98 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $4.79 / $8.71
| Facility | | $4.79 | $4.79 | $8.71 |
- 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
- $6.46 / $11.75 / $20.42
| Facility | | $6.46 | $11.75 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.50 / $7.94
| Professional | | $3.89 | $5.50 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $4.68
| Facility | | $4.27 | $4.27 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $8.51 / $8.51
| Professional | | $0.52 | $8.51 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $5.50
| Facility | | $5.01 | $5.01 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $24.55
| Professional | | $5.01 | $5.01 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $60.26 / $70.79
| Professional | | $50.12 | $60.26 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.03 / $6.46
| Facility | | $5.75 | $6.03 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.75 / $9.55
| Professional | | $4.37 | $5.75 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $7.24 / $14.45
| Professional | | $3.89 | $7.24 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $8.32 / $85.11
| Facility | | $4.27 | $8.32 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $7.41 / $24.55
| Professional | | $4.27 | $7.41 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.79 / $6.46
| Professional | | $3.09 | $4.79 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.25 / $12.30
| Facility | | $3.89 | $5.25 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $6.03
| Professional | | $4.27 | $4.27 | $6.03 |