- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $19.05 / $42.66
| Facility | | $3.98 | $19.05 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.98 / $5.01
| Professional | | $2.00 | $3.98 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.31 / $9.77
| Facility | | $4.47 | $6.31 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.80 / $4.57
| Professional | | $3.24 | $3.80 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $9.55 / $13.80
| Facility | | $4.47 | $9.55 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.51 / $5.62
| Professional | | $2.51 | $2.51 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $32.36 / $75.86
| Professional | | $2.75 | $32.36 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $4.79
| Facility | | $4.27 | $4.27 | $4.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $7.41 / $12.88
| Facility | | $4.27 | $7.41 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $5.25
| Professional | | $3.80 | $3.80 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $6.46 / $11.22
| Facility | | $4.90 | $6.46 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.80 / $4.27
| Professional | | $3.24 | $3.80 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.13 / $5.13
| Facility | | $4.07 | $5.13 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $4.27 / $7.59
| Professional | | $2.57 | $4.27 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $2.19 / $7.76
| Professional | | $1.91 | $2.19 | $7.76 |