- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $16.60 / $89.13
| Facility | | $6.46 | $16.60 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $12.30
| Professional | | $3.98 | $5.01 | $12.30 |
- 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
- $3.16 / $3.16 / $4.79
| Professional | | $3.16 | $3.16 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $30.20 / $45.71
| Professional | | $19.05 | $30.20 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $16.22 / $29.51
| Facility | | $6.61 | $16.22 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $4.79 / $11.22
| Professional | | $3.55 | $4.79 | $11.22 |
- 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 / $12.59
| Professional | | $5.37 | $10.96 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.89 / $6.17
| Facility | | $5.62 | $5.89 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $5.62 / $13.49
| Professional | | $4.47 | $5.62 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $8.71 / $10,000.00
| Facility | | $4.90 | $8.71 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $8.71 / $10,000.00
| Professional | | $4.90 | $8.71 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $6.46 / $11.22
| Facility | | $2.69 | $6.46 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.80 / $6.76
| Professional | | $2.69 | $3.80 | $6.76 |