- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $26.92 / $74.13
| Facility | | $8.91 | $26.92 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $12.02
| Professional | | $8.91 | $8.91 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $52.48
| Facility | | $12.30 | $12.30 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $9.33
| Professional | | $6.03 | $6.03 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $54.95 / $81.28
| Professional | | $34.67 | $54.95 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $32.36 / $54.95
| Facility | | $12.59 | $32.36 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $8.91 / $17.38
| Professional | | $6.76 | $8.91 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $14.79 / $18.20
| Professional | | $12.30 | $14.79 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $20.42 / $23.99
| Professional | | $10.23 | $20.42 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $11.22 / $11.48
| Facility | | $10.47 | $11.22 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $21.38 / $25.70
| Professional | | $10.47 | $21.38 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $17.78 / $10,000.00
| Facility | | $9.55 | $17.78 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $17.38 / $10,000.00
| Professional | | $9.55 | $17.38 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $12.30 / $20.89
| Facility | | $5.13 | $12.30 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $7.24 / $12.30
| Professional | | $5.13 | $7.24 | $12.30 |