- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $11.22 / $79.43
| Facility | | $2.82 | $11.22 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.75 / $11.22
| Professional | | $2.00 | $2.75 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $2.82 / $3.80
| Professional | | $2.40 | $2.82 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $25.12 / $33.11
| Professional | | $2.75 | $25.12 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.27 / $12.02
| Facility | | $2.69 | $4.27 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.02 / $588.84
| Professional | | $2.69 | $3.02 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.72 / $6.03
| Professional | | $3.24 | $3.72 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $11.22 / $16.22
| Professional | | $4.37 | $11.22 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $4.90 / $5.89
| Professional | | $2.57 | $4.90 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $13.18
| Facility | | $5.01 | $5.01 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.02 / $3.72
| Professional | | $2.75 | $3.02 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $3.02 / $3.02
| Facility | | $2.95 | $3.02 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $2.95 / $3.02
| Professional | | $2.40 | $2.95 | $3.02 |