- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $46.77 / $123.03
| Facility | | $7.76 | $46.77 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $8.51 / $53.70
| Professional | | $5.01 | $8.51 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.24 / $3.24
| Professional | | $3.24 | $3.24 | $3.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $22.91
| Facility | | $6.46 | $6.46 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $5.75 / $16.22
| Professional | | $3.24 | $5.75 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $13.18 / $14.79
| Facility | | $12.30 | $13.18 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $12.30 / $36.31
| Facility | | $8.71 | $12.30 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $6.61 / $16.98
| Professional | | $3.47 | $6.61 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $11.48 / $100.00
| Facility | | $5.89 | $11.48 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.89 / $7.94
| Professional | | $2.69 | $3.89 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $6.46 / $7.94
| Facility | | $2.95 | $6.46 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.89 / $8.32
| Professional | | $2.69 | $3.89 | $8.32 |