- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $40.74 / $89.13
| Facility | | $6.61 | $40.74 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $8.51
| Professional | | $3.02 | $3.98 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $21.38
| Facility | | $5.01 | $5.01 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.02 / $3.80
| Professional | | $2.57 | $3.02 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $14.79 / $22.39
| Professional | | $9.33 | $14.79 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $9.12 / $22.39
| Facility | | $5.13 | $9.12 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $3.98 / $7.24
| Professional | | $2.29 | $3.98 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $7.41
| Professional | | $5.01 | $6.03 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $5.37 / $6.17
| Professional | | $2.63 | $5.37 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.63 / $4.27
| Facility | | $2.69 | $3.63 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.07 / $10.47
| Professional | | $2.69 | $4.07 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $6.17 / $10,000.00
| Facility | | $3.55 | $6.17 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $6.03 / $10,000.00
| Professional | | $3.55 | $6.03 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $5.01 / $6.03
| Facility | | $2.14 | $5.01 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.02 / $5.01
| Professional | | $2.51 | $3.02 | $5.01 |