- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $19.95 / $41.69
| Facility | | $6.03 | $19.95 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $7.94
| Professional | | $6.03 | $6.03 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $38.02
| Facility | | $8.91 | $8.91 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $3.63 / $6.03
| Professional | | $3.63 | $3.63 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $32.36 / $48.98
| Professional | | $20.42 | $32.36 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $17.38 / $39.81
| Facility | | $9.12 | $17.38 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $5.37 / $12.02
| Professional | | $4.47 | $5.37 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.72 / $13.18
| Professional | | $8.91 | $10.72 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $11.48 / $13.49
| Professional | | $5.75 | $11.48 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.61 / $7.59
| Facility | | $5.75 | $6.61 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $16.22 / $19.05
| Professional | | $5.75 | $16.22 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $11.75 / $10,000.00
| Facility | | $6.61 | $11.75 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $11.75 / $10,000.00
| Professional | | $6.61 | $11.75 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $8.91 / $11.75
| Facility | | $3.80 | $8.91 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.27 / $7.24
| Professional | | $3.80 | $4.27 | $7.24 |