- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $58.88 / $100.00
| Facility | | $14.13 | $58.88 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.68 / $31.62
| Professional | | $3.98 | $4.68 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.80 / $14.13
| Facility | | $10.96 | $13.80 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.51 / $20.42
| Professional | | $2.51 | $2.51 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $5.37
| Facility | | $3.47 | $3.47 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $5.13
| Professional | | $5.13 | $5.13 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $16.98 / $26.92
| Facility | | $14.45 | $16.98 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.24 / $16.22
| Professional | | $5.75 | $7.24 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $11.22 / $40.74
| Facility | | $4.57 | $11.22 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $26.30 / $66.07
| Facility | | $4.57 | $26.30 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.27 / $14.45
| Professional | | $3.02 | $4.27 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $14.13 / $64.57
| Professional | | $4.37 | $14.13 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $14.79
| Facility | | $6.17 | $6.17 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $8.51 / $14.45
| Professional | | $3.89 | $8.51 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $12.88 / $48.98
| Professional | | $6.61 | $12.88 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $100.00
| Facility | | $10.23 | $10.23 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.47 / $5.01
| Professional | | $2.75 | $3.47 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $10.96
| Professional | | $6.03 | $6.03 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $28.18
| Professional | | $6.03 | $6.03 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $4.57 / $12.02
| Facility | | $2.57 | $4.57 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $4.17 / $12.88
| Professional | | $2.19 | $4.17 | $12.88 |