- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $58.88 / $120.23
| Facility | | $11.22 | $58.88 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $19.05
| Professional | | $6.03 | $7.08 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $34.67
| Facility | | $8.13 | $8.13 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.90 / $6.31
| Professional | | $4.17 | $4.90 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $38.90 / $57.54
| Professional | | $23.99 | $38.90 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $20.89 / $37.15
| Facility | | $8.32 | $20.89 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.03 / $12.30
| Professional | | $4.47 | $6.03 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $9.77 / $12.02
| Professional | | $8.13 | $9.77 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $13.80 / $15.85
| Professional | | $6.76 | $13.80 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.41 / $8.13
| Facility | | $7.08 | $7.41 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $7.08 / $16.98
| Professional | | $3.98 | $7.08 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $11.75 / $10,000.00
| Facility | | $6.31 | $11.75 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $11.75 / $10,000.00
| Professional | | $6.31 | $11.75 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $8.13 / $14.13
| Facility | | $3.47 | $8.13 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $6.92 / $11.48
| Professional | | $4.90 | $6.92 | $11.48 |