- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $15.49 / $83.18
| Facility | | $5.37 | $15.49 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.89 / $8.71
| Professional | | $3.02 | $3.89 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $18.62
| Facility | | $4.37 | $4.37 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $2.63 / $3.31
| Professional | | $2.19 | $2.63 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $20.42 / $30.90
| Professional | | $12.88 | $20.42 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $11.48 / $19.50
| Facility | | $4.47 | $11.48 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.72 / $7.94
| Professional | | $2.57 | $3.72 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.25 / $6.46
| Professional | | $4.37 | $5.25 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $7.24 / $8.51
| Professional | | $3.63 | $7.24 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $3.98 / $4.37
| Facility | | $3.72 | $3.98 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.72 / $9.12
| Professional | | $3.24 | $3.72 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $7.41 / $10,000.00
| Facility | | $3.89 | $7.41 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $7.41 / $10,000.00
| Professional | | $3.89 | $7.41 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $4.37 / $7.41
| Facility | | $1.82 | $4.37 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $2.63 / $4.57
| Professional | | $1.82 | $2.63 | $4.57 |