- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $3.47 / $4.17
| Facility | | $1.78 | $3.47 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.00 / $2.63
| Professional | | $2.00 | $2.00 | $2.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $2.63 / $5.50
| Facility | | $1.78 | $2.63 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $3.80
| Professional | | $3.80 | $3.80 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $6.92 / $8.91
| Facility | | $3.55 | $6.92 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $3.80
| Professional | | $3.80 | $3.80 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.24 / $5.25
| Facility | | $2.00 | $2.24 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.24 / $4.37
| Professional | | $2.00 | $2.24 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $2.09 / $75.86
| Professional | | $1.74 | $2.09 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.14 / $3.89
| Facility | | $1.86 | $2.14 | $3.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $2.51 / $4.47
| Facility | | $1.45 | $2.51 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $2.34 / $2.34
| Professional | | $1.91 | $2.34 | $2.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $2.69 / $5.50
| Facility | | $1.78 | $2.69 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $3.80
| Professional | | $3.80 | $3.80 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $2.95 / $4.17
| Facility | | $1.15 | $2.95 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $2.00 / $2.00
| Professional | | $1.74 | $2.00 | $2.00 |