- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $8.71 / $60.26
| Facility | | $3.39 | $8.71 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.95 / $4.57
| Professional | | $2.00 | $2.95 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $6.61 / $19.95
| Facility | | $3.31 | $6.61 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.55 / $5.62
| Professional | | $3.09 | $3.55 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.07 / $4.07
| Facility | | $4.07 | $4.07 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.09 / $3.09
| Facility | | $3.09 | $3.09 | $3.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.17 / $4.17
| Professional | | $4.17 | $4.17 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.46 / $10.23
| Facility | | $5.75 | $6.46 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.09 / $3.80
| Professional | | $3.09 | $3.09 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $6.92 / $42.66
| Facility | | $2.75 | $6.92 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $2.95 / $9.33
| Professional | | $2.95 | $2.95 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $3.63 / $4.37
| Professional | | $2.95 | $3.63 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $5.13 / $7.08
| Professional | | $2.88 | $5.13 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $7.76 / $7.76
| Facility | | $4.47 | $7.76 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $2.95 / $3.63
| Professional | | $2.95 | $2.95 | $3.63 |