- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $8.32 / $46.77
| Facility | | $2.29 | $8.32 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.69 / $5.62
| Professional | | $2.00 | $2.69 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $12.88
| Facility | | $3.02 | $3.02 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $1.82 / $2.34
| Professional | | $1.55 | $1.82 | $2.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $14.45 / $21.38
| Professional | | $8.91 | $14.45 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $7.94 / $13.49
| Facility | | $3.09 | $7.94 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $2.14 / $5.13
| Professional | | $1.58 | $2.14 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.63 / $4.47
| Professional | | $3.02 | $3.63 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $5.13 / $5.89
| Professional | | $2.51 | $5.13 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $2.75 / $2.88
| Facility | | $2.75 | $2.75 | $2.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $2.88 / $6.46
| Professional | | $2.75 | $2.88 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.90 / $10,000.00
| Facility | | $2.69 | $4.90 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $5.13 / $10,000.00
| Professional | | $2.69 | $5.13 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $3.02 / $5.25
| Facility | | $1.29 | $3.02 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $2.51 / $4.27
| Professional | | $1.82 | $2.51 | $4.27 |