- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $34.67 / $87.10
| Facility | | $7.08 | $34.67 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.89 / $16.98
| Professional | | $3.02 | $3.89 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.59 / $12.88
| Facility | | $10.23 | $12.59 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.14 / $19.05
| Professional | | $2.14 | $2.14 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.24 / $5.01
| Facility | | $3.24 | $3.24 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $4.68
| Professional | | $4.68 | $4.68 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $14.79 / $23.44
| Facility | | $12.59 | $14.79 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.24 / $14.79
| Professional | | $5.75 | $7.24 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $9.55 / $34.67
| Facility | | $3.80 | $9.55 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.47 / $47.86
| Facility | | $3.80 | $4.47 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.55 / $9.77
| Professional | | $2.51 | $3.55 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $32.36 / $85.11
| Professional | | $2.34 | $32.36 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $12.30
| Facility | | $5.62 | $5.62 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $7.76 / $13.49
| Professional | | $3.55 | $7.76 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $12.02 / $39.81
| Professional | | $6.17 | $12.02 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $9.55 / $100.00
| Facility | | $9.55 | $9.55 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.75 / $4.17
| Professional | | $2.51 | $2.75 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $12.88
| Professional | | $10.00 | $10.00 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $13.80 / $26.30
| Professional | | $12.88 | $13.80 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $3.80 / $5.62
| Facility | | $2.34 | $3.80 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.63 / $9.77
| Professional | | $2.00 | $3.63 | $9.77 |