- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $57.54 / $97.72
| Facility | | $9.55 | $57.54 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.75 / $7.76
| Professional | | $3.98 | $5.75 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $27.54
| Facility | | $6.46 | $6.46 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.89 / $5.01
| Professional | | $3.31 | $3.89 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $30.90 / $45.71
| Professional | | $19.50 | $30.90 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $17.38 / $29.51
| Facility | | $6.61 | $17.38 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $4.90 / $9.33
| Professional | | $3.55 | $4.90 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.76 / $9.55
| Professional | | $6.46 | $7.76 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $10.96 / $12.88
| Professional | | $5.37 | $10.96 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $6.46
| Facility | | $5.62 | $5.62 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $7.08 / $13.80
| Professional | | $5.62 | $7.08 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $10.96 / $10,000.00
| Facility | | $5.75 | $10.96 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $11.48 / $10,000.00
| Professional | | $5.75 | $11.48 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $6.46 / $11.22
| Facility | | $2.75 | $6.46 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.89 / $7.08
| Professional | | $2.75 | $3.89 | $7.08 |