- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $32.36 / $100.00
| Facility | | $8.13 | $32.36 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.61 / $11.48
| Professional | | $6.03 | $6.61 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.90 / $15.14
| Professional | | $3.47 | $4.90 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $12.02 / $16.22
| Facility | | $8.51 | $12.02 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $7.41 / $8.13
| Professional | | $6.17 | $7.41 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $18.20 / $26.30
| Facility | | $8.51 | $18.20 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $8.71 / $12.88
| Professional | | $5.13 | $8.71 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $7.24 / $8.71
| Professional | | $5.25 | $7.24 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $16.60
| Facility | | $8.13 | $8.13 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.91 / $9.77
| Professional | | $8.13 | $8.91 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $13.18 / $22.39
| Facility | | $8.13 | $13.18 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $9.77
| Professional | | $7.41 | $7.41 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $12.30 / $21.88
| Facility | | $9.33 | $12.30 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $7.41 / $8.13
| Professional | | $6.17 | $7.41 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.77 / $9.77
| Facility | | $7.41 | $9.77 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.68 / $11.48
| Professional | | $3.47 | $4.68 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $4.27 / $14.79
| Professional | | $3.72 | $4.27 | $14.79 |