- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $16.98 / $74.13
| Facility | | $6.17 | $16.98 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.68 / $10.23
| Professional | | $3.98 | $4.68 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $7.24 / $100.00
| Facility | | $4.68 | $7.24 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $5.75 / $14.13
| Professional | | $3.16 | $5.75 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.88 / $18.62
| Facility | | $10.23 | $12.88 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $6.61
| Professional | | $5.37 | $5.37 | $6.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $8.32 / $19.95
| Facility | | $4.17 | $8.32 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $6.61 / $15.49
| Professional | | $3.55 | $6.61 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $34.67 / $7,079.46
| Facility | | $5.89 | $34.67 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $10.00
| Professional | | $8.32 | $8.32 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $14.13
| Professional | | $5.75 | $5.75 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.76 / $12.02
| Facility | | $4.68 | $6.76 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $7.24 / $100.00
| Facility | | $4.68 | $7.24 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $5.75 / $14.13
| Professional | | $3.16 | $5.75 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.62 / $8.71
| Professional | | $5.13 | $5.62 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $5.75 / $7.59
| Facility | | $2.88 | $5.75 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $4.57 / $13.18
| Professional | | $3.16 | $4.57 | $13.18 |