- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $10.96 / $83.18
| Facility | | $2.63 | $10.96 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.57 / $8.51
| Professional | | $2.00 | $2.57 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $2.57 / $2.69
| Professional | | $2.57 | $2.57 | $2.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $4.57 / $7.08
| Facility | | $2.95 | $4.57 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.95 / $5.37
| Professional | | $2.69 | $2.95 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $2.95 / $2.95
| Professional | | $2.75 | $2.95 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $5.89 / $7.76
| Facility | | $3.72 | $5.89 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $3.02
| Professional | | $2.69 | $2.69 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $2.69 / $4.47
| Facility | | $2.24 | $2.69 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $2.40 / $40.74
| Professional | | $2.24 | $2.40 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $4.07
| Facility | | $3.47 | $3.47 | $4.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.75 / $3.31
| Professional | | $2.34 | $2.75 | $3.31 |