- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $22.91 / $107.15
| Facility | | $9.33 | $22.91 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.71 / $10.00
| Professional | | $7.08 | $8.71 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $41.69
| Facility | | $10.00 | $10.00 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $4.90 / $7.59
| Professional | | $4.90 | $4.90 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $46.77 / $69.18
| Professional | | $29.51 | $46.77 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $24.55 / $44.67
| Facility | | $10.00 | $24.55 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $7.41 / $16.98
| Professional | | $5.37 | $7.41 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $11.75 / $14.79
| Professional | | $10.00 | $11.75 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $16.60 / $19.50
| Professional | | $7.08 | $16.60 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.91 / $9.33
| Facility | | $8.51 | $8.91 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $18.62 / $20.89
| Professional | | $8.51 | $18.62 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $14.45 / $10,000.00
| Facility | | $7.76 | $14.45 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $14.13 / $10,000.00
| Professional | | $7.76 | $14.13 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $10.00 / $16.98
| Facility | | $4.17 | $10.00 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.89 / $10.47
| Professional | | $4.17 | $5.89 | $10.47 |