- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $8.32 / $181.97
| Facility | | $4.68 | $8.32 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $7.24
| Professional | | $3.98 | $3.98 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $4.27
| Facility | | $4.27 | $4.27 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.27 / $4.27
| Professional | | $3.89 | $4.27 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $17.78
| Facility | | $5.75 | $5.75 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $3.89 / $4.68
| Professional | | $3.89 | $3.89 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.07 / $8.32
| Facility | | $3.89 | $4.07 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.07 / $8.71
| Professional | | $3.89 | $4.07 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.57 / $75.86
| Professional | | $3.80 | $4.57 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.55 / $7.08
| Facility | | $3.47 | $3.55 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.03 / $6.03
| Facility | | $4.47 | $6.03 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.47 / $4.47
| Professional | | $4.47 | $4.47 | $4.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $4.27
| Facility | | $4.27 | $4.27 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.27 / $4.27
| Professional | | $3.89 | $4.27 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $4.47 / $10.47
| Facility | | $2.95 | $4.47 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.37 / $5.13
| Professional | | $4.07 | $4.37 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $3.89 / $5.01
| Professional | | $3.89 | $3.89 | $5.01 |