- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $21.38 / $107.15
| Facility | | $4.68 | $21.38 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.31 / $5.89
| Professional | | $2.00 | $3.31 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $3.63 / $15.49
| Facility | | $3.63 | $3.63 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.19 / $2.82
| Professional | | $1.86 | $2.19 | $2.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $17.38 / $25.70
| Professional | | $10.96 | $17.38 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $9.55 / $16.22
| Facility | | $3.72 | $9.55 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.69 / $6.46
| Professional | | $1.95 | $2.69 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.37 / $5.37
| Professional | | $3.63 | $4.37 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $6.17 / $7.08
| Professional | | $3.02 | $6.17 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.31 / $3.63
| Facility | | $3.16 | $3.31 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $5.62 / $7.76
| Professional | | $3.16 | $5.62 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $6.17 / $10,000.00
| Facility | | $3.24 | $6.17 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $6.46 / $10,000.00
| Professional | | $3.24 | $6.46 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $3.63 / $6.31
| Facility | | $1.55 | $3.63 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $2.19 / $3.80
| Professional | | $1.55 | $2.19 | $3.80 |