- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $93.33 / $891.25
| Facility | | $13.49 | $93.33 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $9.12 / $48.98
| Professional | | $3.63 | $9.12 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $4.79 / $11.75
| Professional | | $1.86 | $4.79 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $9.77 / $17.38
| Facility | | $8.51 | $9.77 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $6.92 / $12.30
| Professional | | $2.45 | $6.92 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $6.31 / $12.88
| Facility | | $6.31 | $6.31 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $9.12
| Professional | | $7.41 | $7.41 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $9.55 / $11.48
| Facility | | $3.02 | $9.55 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $9.12 / $12.30
| Professional | | $5.89 | $9.12 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $10.00 / $17.38
| Facility | | $2.29 | $10.00 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $6.17 / $8.32
| Professional | | $2.63 | $6.17 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $12.88 / $25.12
| Facility | | $3.89 | $12.88 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $6.03 / $13.80
| Professional | | $3.02 | $6.03 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $8.13 / $11.22
| Professional | | $6.76 | $8.13 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $12.30 / $100.00
| Facility | | $4.68 | $12.30 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $8.71 / $16.22
| Professional | | $3.63 | $8.71 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $9.33 / $12.88
| Facility | | $3.39 | $9.33 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $3.02 / $26.92
| Professional | | $1.82 | $3.02 | $26.92 |