- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $16.98 / $93.33
| Facility | | $5.01 | $16.98 | $93.33 |
- 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
- $5.50 / $5.50 / $23.44
| Facility | | $5.50 | $5.50 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $4.27
| Professional | | $2.69 | $2.69 | $4.27 |
- 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
- $5.62 / $14.13 / $25.12
| Facility | | $5.62 | $14.13 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.57 / $7.76
| Professional | | $3.09 | $4.57 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $6.61 / $8.13
| Professional | | $5.50 | $6.61 | $8.13 |
- 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
- $4.68 / $5.01 / $5.25
| Facility | | $4.68 | $5.01 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.68 / $11.48
| Professional | | $3.98 | $4.68 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $9.12 / $10,000.00
| Facility | | $4.90 | $9.12 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $9.33 / $10,000.00
| Professional | | $4.90 | $9.33 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $5.50 / $9.55
| Facility | | $2.29 | $5.50 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $3.31 / $7.76
| Professional | | $2.29 | $3.31 | $7.76 |