- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $10.00 / $27.54
| Facility | | $3.02 | $10.00 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $3.98
| Professional | | $3.02 | $3.02 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $4.57 / $19.50
| Facility | | $4.57 | $4.57 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $2.24 / $3.47
| Professional | | $2.24 | $2.24 | $3.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $21.38 / $32.36
| Professional | | $13.49 | $21.38 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $11.48 / $20.89
| Facility | | $4.68 | $11.48 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.39 / $6.76
| Professional | | $2.51 | $3.39 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.50 / $6.76
| Professional | | $4.57 | $5.50 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $7.59 / $8.91
| Professional | | $3.80 | $7.59 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.90 / $4.90
| Facility | | $3.89 | $4.90 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $3.89 / $9.55
| Professional | | $1.62 | $3.89 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $6.46 / $10,000.00
| Facility | | $3.55 | $6.46 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $6.46 / $10,000.00
| Professional | | $3.55 | $6.46 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $4.57 / $7.76
| Facility | | $1.91 | $4.57 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $2.75 / $4.79
| Professional | | $1.91 | $2.75 | $4.79 |