- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $7.94 / $10.96
| Facility | | $3.98 | $7.94 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $7.08
| Professional | | $3.02 | $3.98 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $13.18 / $39.81
| Facility | | $6.61 | $13.18 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.61 / $11.48
| Professional | | $5.75 | $6.61 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $4.37
| Facility | | $4.37 | $4.37 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $5.89 / $5.89
| Professional | | $5.89 | $5.89 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $12.88 / $19.95
| Facility | | $11.48 | $12.88 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $16.98
| Professional | | $6.03 | $6.03 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $3.72 / $3.98
| Facility | | $3.72 | $3.72 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $35.48
| Professional | | $3.98 | $3.98 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.90 / $6.17
| Professional | | $3.98 | $4.90 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $10.23 / $14.13
| Professional | | $5.62 | $10.23 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $10.00 / $10.00
| Facility | | $5.62 | $10.00 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $5.25
| Professional | | $3.98 | $3.98 | $5.25 |