- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $5.75 / $288.40
| Facility | | $3.31 | $5.75 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.31 / $323.59
| Professional | | $3.02 | $3.31 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $5.13
| Professional | | $5.13 | $5.13 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.72 / $4.27
| Facility | | $2.82 | $3.72 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $3.72 / $3.72
| Professional | | $3.39 | $3.72 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $5.13 / $6.76
| Facility | | $3.31 | $5.13 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $3.39 / $4.17
| Professional | | $3.39 | $3.39 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.39 / $7.94
| Facility | | $3.31 | $3.39 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.39 / $6.76
| Professional | | $3.31 | $3.39 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.63 / $75.86
| Professional | | $3.24 | $3.63 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.63 / $6.76
| Facility | | $3.24 | $3.63 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $3.55 / $3.72
| Facility | | $3.55 | $3.55 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $3.72 / $3.72
| Professional | | $3.72 | $3.72 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.72 / $4.27
| Facility | | $2.82 | $3.72 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $3.72 / $3.72
| Professional | | $3.39 | $3.72 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $3.39 / $3.39
| Facility | | $3.39 | $3.39 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.31 / $3.63
| Professional | | $3.16 | $3.31 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $3.39 / $4.37
| Professional | | $3.39 | $3.39 | $4.37 |