- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $28.84 / $48.98
| Facility | | $8.91 | $28.84 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $8.91 / $12.02
| Professional | | $7.94 | $8.91 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $56.23
| Facility | | $13.18 | $13.18 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $8.91
| Professional | | $5.25 | $5.25 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $36.31 / $54.95
| Professional | | $22.91 | $36.31 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $22.91 / $58.88
| Facility | | $13.49 | $22.91 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.61 / $13.18
| Professional | | $5.13 | $6.61 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $15.85 / $19.50
| Professional | | $13.18 | $15.85 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $12.88 / $15.14
| Professional | | $6.46 | $12.88 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $9.55 / $11.22
| Facility | | $6.61 | $9.55 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $16.22 / $27.54
| Professional | | $6.61 | $16.22 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $15.49 / $10,000.00
| Facility | | $9.12 | $15.49 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $15.49 / $10,000.00
| Professional | | $9.12 | $15.49 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $13.18 / $15.85
| Facility | | $5.50 | $13.18 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.89 / $10.47
| Professional | | $4.57 | $5.89 | $10.47 |