- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $70.79 / $144.54
| Facility | | $14.79 | $70.79 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $12.30
| Professional | | $5.01 | $6.03 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $28.18
| Facility | | $6.76 | $6.76 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $5.13
| Professional | | $3.31 | $3.31 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $31.62 / $46.77
| Professional | | $19.95 | $31.62 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $17.78 / $29.51
| Facility | | $6.76 | $17.78 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.90 / $9.77
| Professional | | $3.80 | $4.90 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $7.94 / $10.00
| Professional | | $6.76 | $7.94 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $11.22 / $13.18
| Professional | | $5.62 | $11.22 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.89 / $6.31
| Facility | | $5.75 | $5.89 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.75 / $14.13
| Professional | | $5.62 | $5.75 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $11.22 / $10,000.00
| Facility | | $5.89 | $11.22 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $11.48 / $10,000.00
| Professional | | $5.89 | $11.48 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $6.76 / $11.48
| Facility | | $2.82 | $6.76 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.98 / $9.33
| Professional | | $2.82 | $3.98 | $9.33 |