- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $23.44 / $61.66
| Facility | | $7.94 | $23.44 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $10.47
| Professional | | $7.94 | $7.94 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $45.71
| Facility | | $10.72 | $10.72 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $8.32
| Professional | | $5.13 | $5.13 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $48.98 / $72.44
| Professional | | $30.90 | $48.98 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $26.92 / $48.98
| Facility | | $10.96 | $26.92 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.59 / $17.38
| Professional | | $5.75 | $7.59 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $12.88 / $15.85
| Professional | | $10.72 | $12.88 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $17.38 / $19.95
| Professional | | $8.51 | $17.38 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $9.33 / $9.77
| Facility | | $8.91 | $9.33 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.59 / $22.39
| Professional | | $8.91 | $12.59 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $15.14 / $10,000.00
| Facility | | $7.94 | $15.14 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $15.14 / $10,000.00
| Professional | | $7.94 | $15.14 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $10.72 / $17.78
| Facility | | $4.47 | $10.72 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.31 / $10.72
| Professional | | $4.47 | $6.31 | $10.72 |