- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $44.67 / $97.72
| Facility | | $6.31 | $44.67 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.17 / $22.91
| Professional | | $3.02 | $4.17 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.30 / $12.59
| Facility | | $10.00 | $12.30 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $2.29 / $18.20
| Professional | | $2.29 | $2.29 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.09 / $4.79
| Facility | | $3.09 | $3.09 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $4.57 / $4.57
| Professional | | $4.57 | $4.57 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $14.79 / $23.44
| Facility | | $12.59 | $14.79 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $6.76 / $14.45
| Professional | | $5.37 | $6.76 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $10.00 / $36.31
| Facility | | $4.07 | $10.00 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $5.50 / $66.07
| Facility | | $3.72 | $5.50 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.80 / $10.47
| Professional | | $2.69 | $3.80 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $16.22 / $64.57
| Professional | | $4.57 | $16.22 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $13.18
| Facility | | $5.50 | $5.50 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $7.59 / $12.88
| Professional | | $3.47 | $7.59 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $11.75 / $48.98
| Professional | | $6.17 | $11.75 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $100.00
| Facility | | $9.12 | $9.12 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $3.09 / $4.47
| Professional | | $2.45 | $3.09 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $9.77
| Professional | | $6.03 | $6.03 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $18.20 / $28.18
| Professional | | $6.03 | $18.20 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $4.07 / $5.50
| Facility | | $2.29 | $4.07 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.72 / $10.47
| Professional | | $2.00 | $3.72 | $10.47 |