- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $8.91 / $14.79
| Facility | | $3.02 | $8.91 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.02 / $3.39
| Professional | | $2.00 | $3.02 | $3.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $16.98
| Facility | | $3.98 | $3.98 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.40 / $3.02
| Professional | | $2.04 | $2.40 | $3.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $11.22 / $16.60
| Professional | | $7.08 | $11.22 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $7.08 / $17.78
| Facility | | $4.07 | $7.08 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $3.09 / $4.27
| Professional | | $1.66 | $3.09 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.79 / $5.89
| Professional | | $3.98 | $4.79 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $3.98 / $4.57
| Professional | | $1.95 | $3.98 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.95 / $3.39
| Facility | | $2.04 | $2.95 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $3.72 / $8.51
| Professional | | $2.04 | $3.72 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.57 / $10,000.00
| Facility | | $2.69 | $4.57 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.79 / $10,000.00
| Professional | | $2.69 | $4.79 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $3.98 / $4.79
| Facility | | $1.70 | $3.98 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.40 / $3.98
| Professional | | $1.95 | $2.40 | $3.98 |