- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $54.95 / $131.83
| Facility | | $7.41 | $54.95 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.37 / $6.92
| Professional | | $3.02 | $4.37 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $21.38
| Facility | | $5.01 | $5.01 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.02 / $3.89
| Professional | | $2.51 | $3.02 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $23.44 / $35.48
| Professional | | $14.79 | $23.44 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $13.18 / $22.39
| Facility | | $5.13 | $13.18 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.80 / $8.13
| Professional | | $2.69 | $3.80 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $7.41
| Professional | | $5.01 | $6.03 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $8.51 / $9.77
| Professional | | $2.88 | $8.51 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.37 / $4.68
| Facility | | $4.27 | $4.37 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $4.27 / $10.47
| Professional | | $3.72 | $4.27 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $8.51 / $10,000.00
| Facility | | $4.47 | $8.51 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $8.51 / $10,000.00
| Professional | | $4.47 | $8.51 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $5.01 / $8.71
| Facility | | $2.09 | $5.01 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $3.02 / $5.50
| Professional | | $2.09 | $3.02 | $5.50 |