- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $14.13 / $29.51
| Facility | | $3.98 | $14.13 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $6.03
| Professional | | $3.98 | $3.98 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $27.54
| Facility | | $6.46 | $6.46 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $2.57 / $4.37
| Professional | | $2.57 | $2.57 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $23.44 / $34.67
| Professional | | $14.79 | $23.44 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $12.59 / $29.51
| Facility | | $6.61 | $12.59 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.89 / $8.51
| Professional | | $3.24 | $3.89 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.76 / $9.55
| Professional | | $6.46 | $7.76 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.32 / $9.77
| Professional | | $4.07 | $8.32 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.68 / $5.50
| Facility | | $4.27 | $4.68 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $10.47 / $13.49
| Professional | | $4.27 | $10.47 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $8.51 / $10,000.00
| Facility | | $4.79 | $8.51 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $8.51 / $10,000.00
| Professional | | $4.79 | $8.51 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $6.46 / $8.51
| Facility | | $2.75 | $6.46 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.16 / $6.46
| Professional | | $2.75 | $3.16 | $6.46 |