- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $93.33 / $281.84
| Facility | | $15.14 | $93.33 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.94 / $30.90
| Professional | | $5.01 | $7.94 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.27 / $11.22
| Professional | | $3.47 | $4.27 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $8.71 / $10.00
| Facility | | $7.59 | $8.71 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $8.71 / $12.02
| Professional | | $6.92 | $8.71 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $7.76 / $22.39
| Facility | | $5.25 | $7.76 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $7.41 / $12.88
| Professional | | $4.27 | $7.41 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $26.92 / $60.26
| Facility | | $6.31 | $26.92 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $8.91
| Professional | | $5.13 | $5.13 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $4.17 / $5.13
| Professional | | $1.02 | $4.17 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $5.13 / $8.71
| Facility | | $3.63 | $5.13 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.13 / $9.33
| Professional | | $3.89 | $5.13 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $8.13
| Professional | | $5.13 | $5.13 | $8.13 |