- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $18.62 / $93.33
| Facility | | $7.94 | $18.62 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $7.08 / $13.49
| Professional | | $2.00 | $7.08 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $3.55 / $10.23
| Professional | | $3.55 | $3.55 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $8.32 / $13.18
| Professional | | $6.46 | $8.32 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.72 / $11.48
| Facility | | $8.32 | $10.72 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $11.22 / $19.95
| Professional | | $8.32 | $11.22 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.27 / $0.36 / $9.77
| Facility | | $0.27 | $0.36 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $5.50 / $8.32
| Professional | | $2.63 | $5.50 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $9.33 / $21.38
| Facility | | $2.04 | $9.33 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $7.76 / $8.51
| Professional | | $2.63 | $7.76 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $3.39 / $3.98
| Professional | | $3.39 | $3.39 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $70.79 / $75.86
| Professional | | $60.26 | $70.79 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $12.59 / $12.59
| Facility | | $3.80 | $12.59 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $3.02 / $5.01
| Professional | | $1.58 | $3.02 | $5.01 |