- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $28.18 / $72.44
| Facility | | $6.76 | $28.18 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.27 / $13.49
| Professional | | $3.02 | $4.27 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.61 / $100.00
| Facility | | $4.37 | $6.61 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $4.79 / $11.48
| Professional | | $2.34 | $4.79 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $11.48 / $16.60
| Facility | | $9.12 | $11.48 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $6.03
| Professional | | $6.03 | $6.03 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $7.59 / $18.20
| Facility | | $3.72 | $7.59 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $5.75 / $12.59
| Professional | | $2.82 | $5.75 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $39.81 / $7,079.46
| Facility | | $5.37 | $39.81 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $8.32
| Professional | | $7.08 | $7.08 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $4.79 / $12.88
| Professional | | $4.79 | $4.79 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.08 / $41.69
| Facility | | $5.75 | $7.08 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.61 / $100.00
| Facility | | $4.37 | $6.61 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $4.79 / $11.48
| Professional | | $2.34 | $4.79 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.37 / $11.22
| Facility | | $4.17 | $5.37 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.79 / $7.08
| Professional | | $4.17 | $4.79 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $4.79 / $7.76
| Facility | | $2.34 | $4.79 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $3.98 / $12.88
| Professional | | $2.09 | $3.98 | $12.88 |