- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.14 / $7.08
| Facility | | $1.86 | $2.14 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.86 / $2.75
| Professional | | $1.00 | $1.86 | $2.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $1.91 / $2.40
| Professional | | $1.86 | $1.91 | $2.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $4.79 / $7.76
| Professional | | $1.82 | $4.79 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $2.04 / $3.09
| Facility | | $1.82 | $2.04 | $3.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.82 / $549.54
| Professional | | $1.82 | $1.82 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.19 / $2.34
| Professional | | $1.95 | $2.19 | $2.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.57 / $3.72
| Professional | | $1.95 | $2.57 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $3.39 / $3.39
| Professional | | $3.39 | $3.39 | $3.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.09 / $3.02
| Facility | | $2.09 | $2.09 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.86 / $2.00
| Professional | | $1.82 | $1.86 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.86 / $1.86
| Facility | | $1.82 | $1.86 | $1.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $1.82 / $1.86
| Professional | | $1.48 | $1.82 | $1.86 |