- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $79.43 / $891.25
| Facility | | $9.12 | $79.43 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $8.91 / $42.66
| Professional | | $2.88 | $8.91 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $18.62
| Facility | | $9.33 | $9.33 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $3.02 / $3.72
| Professional | | $2.45 | $3.02 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $10.96 / $13.49
| Professional | | $6.31 | $10.96 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $7.41 / $26.30
| Facility | | $4.90 | $7.41 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $4.27 / $10.23
| Professional | | $1.51 | $4.27 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $11.22 / $13.80
| Professional | | $9.33 | $11.22 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.32 / $8.51
| Professional | | $6.03 | $8.32 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $5.62 / $9.55
| Facility | | $2.24 | $5.62 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $3.89 / $3.89
| Professional | | $3.89 | $3.89 | $3.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $5.25 / $10,000.00
| Facility | | $2.40 | $5.25 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $5.25 / $10,000.00
| Professional | | $2.40 | $5.25 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $3.02 / $9.33
| Facility | | $1.82 | $3.02 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.55 / $5.01
| Professional | | $1.26 | $1.55 | $5.01 |