- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $19.50 / $48.98
| Facility | | $6.03 | $19.50 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $8.32
| Professional | | $6.03 | $7.08 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $37.15
| Facility | | $8.71 | $8.71 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.07 / $6.76
| Professional | | $4.07 | $4.07 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $38.90 / $58.88
| Professional | | $24.55 | $38.90 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $19.50 / $39.81
| Facility | | $8.91 | $19.50 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.03 / $14.13
| Professional | | $4.47 | $6.03 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $10.47 / $12.88
| Professional | | $8.71 | $10.47 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $13.80 / $16.22
| Professional | | $6.92 | $13.80 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.59 / $7.94
| Facility | | $7.08 | $7.59 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $16.22 / $18.62
| Professional | | $7.08 | $16.22 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $12.02 / $10,000.00
| Facility | | $6.46 | $12.02 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $12.02 / $10,000.00
| Professional | | $6.46 | $12.02 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $8.71 / $14.13
| Facility | | $3.72 | $8.71 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $5.13 / $8.71
| Professional | | $3.72 | $5.13 | $8.71 |