- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $43.65 / $89.13
| Facility | | $6.03 | $43.65 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.17 / $11.48
| Professional | | $3.02 | $4.17 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $4.79 / $20.42
| Facility | | $4.79 | $4.79 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $2.29 / $3.63
| Professional | | $2.29 | $2.29 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $21.88 / $32.36
| Professional | | $13.49 | $21.88 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $12.30 / $22.39
| Facility | | $4.79 | $12.30 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.63 / $7.94
| Professional | | $2.51 | $3.63 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.75 / $7.08
| Professional | | $4.79 | $5.75 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $7.76 / $8.91
| Professional | | $3.80 | $7.76 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.17 / $4.79
| Facility | | $3.98 | $4.17 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.98 / $10.00
| Professional | | $3.16 | $3.98 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $7.94 / $10,000.00
| Facility | | $4.07 | $7.94 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.13 / $10,000.00
| Professional | | $4.07 | $8.13 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $4.79 / $7.94
| Facility | | $2.00 | $4.79 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.82 / $5.25
| Professional | | $2.00 | $2.82 | $5.25 |