- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $9.33 / $52.48
| Facility | | $3.47 | $9.33 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $7.08
| Professional | | $3.02 | $3.98 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $15.49 / $29.51
| Facility | | $5.50 | $15.49 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $4.79 / $5.50
| Professional | | $2.75 | $4.79 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $7.59 / $31.62
| Facility | | $4.47 | $7.59 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $5.62
| Facility | | $5.01 | $5.01 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $10.96 / $26.92
| Facility | | $5.75 | $10.96 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.63 / $8.13
| Professional | | $2.75 | $3.63 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $100.00
| Facility | | $60.26 | $60.26 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $10.00
| Professional | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $5.01 / $22.39
| Facility | | $3.80 | $5.01 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.01 / $8.91
| Professional | | $3.02 | $5.01 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $4.17 / $4.17
| Professional | | $3.72 | $4.17 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $104.71 / $104.71
| Facility | | $104.71 | $104.71 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.01 / $14.79
| Facility | | $3.89 | $5.01 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.63 / $7.94
| Professional | | $2.75 | $3.63 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $5.01 / $6.03
| Facility | | $2.09 | $5.01 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.82 / $4.79
| Professional | | $2.09 | $2.82 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.57 / $5.01
| Professional | | $1.95 | $2.57 | $5.01 |