- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $22.91 / $67.61
| Facility | | $6.03 | $22.91 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.17 / $8.32
| Professional | | $3.02 | $4.17 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $4.79 / $20.42
| Facility | | $4.79 | $4.79 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $2.82 / $3.63
| Professional | | $2.40 | $2.82 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $22.39 / $33.11
| Professional | | $14.13 | $22.39 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $12.30 / $22.39
| Facility | | $4.79 | $12.30 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.89 / $7.24
| Professional | | $2.69 | $3.89 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.75 / $7.08
| Professional | | $4.79 | $5.75 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $7.94 / $9.33
| Professional | | $3.98 | $7.94 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.17 / $4.79
| Facility | | $4.07 | $4.17 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $4.07 / $10.00
| Professional | | $2.24 | $4.07 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $8.13 / $10,000.00
| Facility | | $4.27 | $8.13 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $8.13 / $10,000.00
| Professional | | $4.27 | $8.13 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $4.79 / $8.13
| Facility | | $2.00 | $4.79 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.98 / $6.61
| Professional | | $2.82 | $3.98 | $6.61 |