- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $13.18 / $36.31
| Facility | | $3.98 | $13.18 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $6.03
| Professional | | $3.98 | $3.98 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $25.70
| Facility | | $6.03 | $6.03 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $2.95 / $4.57
| Professional | | $2.95 | $2.95 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $28.18 / $42.66
| Professional | | $17.78 | $28.18 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $15.85 / $26.92
| Facility | | $6.17 | $15.85 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.37 / $10.23
| Professional | | $3.24 | $4.37 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.24 / $8.91
| Professional | | $6.03 | $7.24 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $10.00 / $11.75
| Professional | | $5.01 | $10.00 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.50 / $5.62
| Facility | | $5.13 | $5.50 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $12.59 / $16.22
| Professional | | $5.13 | $12.59 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $8.71 / $10,000.00
| Facility | | $4.68 | $8.71 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $8.51 / $10,000.00
| Professional | | $4.68 | $8.51 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $6.03 / $10.23
| Facility | | $2.51 | $6.03 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.63 / $6.31
| Professional | | $2.51 | $3.63 | $6.31 |