- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $8.32 / $12.30
| Facility | | $3.98 | $8.32 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $7.94
| Professional | | $3.98 | $3.98 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $8.91 / $15.14
| Facility | | $4.47 | $8.91 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.47 / $7.41
| Professional | | $4.47 | $4.47 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.47 / $6.03
| Professional | | $4.47 | $4.47 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $8.51 / $11.22
| Facility | | $4.68 | $8.51 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.47 / $4.47
| Professional | | $4.47 | $4.47 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.47 / $6.76
| Professional | | $3.80 | $4.47 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $4.47
| Professional | | $3.02 | $3.02 | $4.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.13 / $7.76
| Facility | | $4.37 | $5.13 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.31 / $6.31
| Professional | | $6.03 | $6.31 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.89 / $6.92
| Facility | | $4.27 | $5.89 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.89 / $6.92
| Professional | | $4.27 | $5.89 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.47 / $9.33
| Facility | | $4.37 | $4.47 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.68 / $5.25
| Professional | | $4.47 | $4.68 | $5.25 |