- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $18.62 / $61.66
| Facility | | $3.02 | $18.62 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $4.90 / $9.33
| Professional | | $2.00 | $4.90 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $16.22 / $19.50
| Facility | | $12.59 | $16.22 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $2.88 / $4.27
| Professional | | $2.88 | $2.88 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $9.12 / $13.80
| Professional | | $8.13 | $9.12 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.18 / $4.79 / $7.41
| Facility | | $0.18 | $4.79 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.55 / $10.23
| Professional | | $2.82 | $3.55 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.01 / $6.17
| Professional | | $4.17 | $5.01 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $4.47 / $10.47
| Facility | | $2.40 | $4.47 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.98 / $10,000.00
| Facility | | $2.63 | $3.98 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.98 / $10,000.00
| Professional | | $2.63 | $3.98 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $3.09 / $3.72
| Facility | | $1.74 | $3.09 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $1.74 / $5.01
| Professional | | $1.29 | $1.74 | $5.01 |