- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $12.02 / $93.33
| Facility | | $3.98 | $12.02 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $6.03
| Professional | | $3.02 | $3.98 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $21.38
| Facility | | $5.01 | $5.01 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $2.40 / $3.80
| Professional | | $2.40 | $2.40 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $22.91 / $34.67
| Professional | | $14.45 | $22.91 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $12.30 / $22.39
| Facility | | $5.13 | $12.30 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.55 / $8.51
| Professional | | $2.69 | $3.55 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $7.41
| Professional | | $5.01 | $6.03 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.13 / $9.55
| Professional | | $4.07 | $8.13 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.47 / $4.57
| Facility | | $4.17 | $4.47 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.37 / $10.47
| Professional | | $4.17 | $4.37 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $8.51 / $10,000.00
| Facility | | $4.37 | $8.51 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $8.71 / $10,000.00
| Professional | | $4.37 | $8.71 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $5.01 / $8.32
| Facility | | $2.09 | $5.01 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $3.02 / $5.13
| Professional | | $2.09 | $3.02 | $5.13 |