- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $11.22 / $14.79
| Facility | | $5.01 | $11.22 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $5.01
| Professional | | $5.01 | $5.01 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $10.72 / $18.20
| Facility | | $5.37 | $10.72 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $8.91
| Professional | | $5.37 | $5.37 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $8.32 / $12.59
| Professional | | $7.24 | $8.32 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.00 / $13.49
| Facility | | $7.41 | $10.00 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $5.37
| Professional | | $5.37 | $5.37 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $5.37 / $6.92
| Professional | | $4.47 | $5.37 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $7.76
| Facility | | $5.37 | $5.37 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.50 / $7.76
| Facility | | $5.01 | $5.50 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.50 / $7.76
| Professional | | $5.01 | $5.50 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.03 / $11.22
| Facility | | $5.13 | $6.03 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.37 / $6.46
| Professional | | $5.13 | $5.37 | $6.46 |