- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $24.55 / $41.69
| Facility | | $7.94 | $24.55 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.94 / $10.00
| Professional | | $5.01 | $7.94 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $47.86
| Facility | | $11.22 | $11.22 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.47 / $7.59
| Professional | | $4.47 | $4.47 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $25.70 / $38.90
| Professional | | $16.22 | $25.70 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $19.05 / $50.12
| Facility | | $10.96 | $19.05 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $5.75 / $11.22
| Professional | | $3.55 | $5.75 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $13.49 / $16.60
| Professional | | $11.22 | $13.49 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $9.12 / $10.72
| Professional | | $4.57 | $9.12 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $8.13 / $9.55
| Facility | | $5.37 | $8.13 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $12.02 / $23.44
| Professional | | $4.68 | $12.02 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $14.79 / $10,000.00
| Facility | | $7.94 | $14.79 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $14.79 / $10,000.00
| Professional | | $7.94 | $14.79 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $11.22 / $13.49
| Facility | | $4.57 | $11.22 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.68 / $7.76
| Professional | | $3.24 | $4.68 | $7.76 |