- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $22.91 / $112.20
| Facility | | $6.03 | $22.91 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $9.33
| Professional | | $6.03 | $7.08 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $38.90
| Facility | | $9.12 | $9.12 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $4.57 / $7.08
| Professional | | $4.57 | $4.57 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $43.65 / $64.57
| Professional | | $27.54 | $43.65 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $24.55 / $41.69
| Facility | | $9.33 | $24.55 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.76 / $15.85
| Professional | | $5.01 | $6.76 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $10.96 / $13.80
| Professional | | $9.12 | $10.96 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $15.49 / $18.20
| Professional | | $7.59 | $15.49 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $8.32 / $8.71
| Facility | | $7.94 | $8.32 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $13.49 / $19.50
| Professional | | $7.94 | $13.49 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $15.85 / $10,000.00
| Facility | | $8.13 | $15.85 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $16.22 / $10,000.00
| Professional | | $8.13 | $16.22 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $9.12 / $15.85
| Facility | | $3.89 | $9.12 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.50 / $9.77
| Professional | | $3.89 | $5.50 | $9.77 |