- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $29.51 / $81.28
| Facility | | $6.03 | $29.51 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.47 / $11.48
| Professional | | $3.02 | $4.47 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $4.90 / $20.89
| Facility | | $4.90 | $4.90 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.95 / $3.80
| Professional | | $2.51 | $2.95 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $23.44 / $34.67
| Professional | | $14.79 | $23.44 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $12.59 / $22.39
| Facility | | $5.01 | $12.59 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.55 / $8.13
| Professional | | $2.69 | $3.55 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $5.89 / $7.41
| Professional | | $4.90 | $5.89 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.32 / $9.77
| Professional | | $4.07 | $8.32 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.47 / $4.90
| Facility | | $4.27 | $4.47 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $4.27 / $10.47
| Professional | | $2.88 | $4.27 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $8.32 / $10,000.00
| Facility | | $4.37 | $8.32 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $8.51 / $10,000.00
| Professional | | $4.37 | $8.51 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $4.90 / $8.51
| Facility | | $2.09 | $4.90 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.95 / $5.50
| Professional | | $2.09 | $2.95 | $5.50 |