- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $11.48 / $19.05
| Facility | | $3.98 | $11.48 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $8.51
| Professional | | $3.02 | $3.98 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $6.61 / $100.00
| Facility | | $4.27 | $6.61 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $5.75 / $14.13
| Professional | | $3.47 | $5.75 | $14.13 |
- 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
- $5.50 / $5.50 / $5.50
| Professional | | $5.50 | $5.50 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $7.59 / $16.60
| Facility | | $4.07 | $7.59 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $6.61 / $15.49
| Professional | | $3.31 | $6.61 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $30.90 / $7,079.46
| Facility | | $4.90 | $30.90 | $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 / $13.18
| Professional | | $5.75 | $5.75 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $6.61 / $100.00
| Facility | | $4.27 | $6.61 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $5.75 / $14.13
| Professional | | $3.47 | $5.75 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $5.37 / $6.92
| Facility | | $2.63 | $5.37 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $5.75 / $14.13
| Professional | | $2.88 | $5.75 | $14.13 |