- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $20.89 / $40.74
| Facility | | $7.08 | $20.89 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $7.94
| Professional | | $6.03 | $7.08 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $39.81
| Facility | | $9.33 | $9.33 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $7.24
| Professional | | $4.68 | $4.68 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $31.62 / $47.86
| Professional | | $19.95 | $31.62 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $18.20 / $42.66
| Facility | | $9.55 | $18.20 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $5.62 / $11.48
| Professional | | $4.47 | $5.62 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $11.22 / $14.13
| Professional | | $9.33 | $11.22 | $14.13 |
- 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 / $6.92 / $8.91
| Facility | | $5.75 | $6.92 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.46 / $19.95
| Professional | | $5.75 | $6.46 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $11.75 / $10,000.00
| Facility | | $7.41 | $11.75 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $12.02 / $10,000.00
| Professional | | $7.41 | $12.02 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $9.33 / $11.48
| Facility | | $3.98 | $9.33 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.27 / $9.33
| Professional | | $3.98 | $4.27 | $9.33 |