- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $21.38 / $51.29
| Facility | | $7.08 | $21.38 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $16.22
| Professional | | $7.08 | $7.08 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $41.69
| Facility | | $9.77 | $9.77 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $7.08
| Professional | | $4.27 | $4.27 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $40.74 / $60.26
| Professional | | $25.70 | $40.74 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $22.39 / $44.67
| Facility | | $10.00 | $22.39 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $6.31 / $13.80
| Professional | | $4.79 | $6.31 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $11.75 / $14.45
| Professional | | $9.77 | $11.75 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $14.45 / $16.98
| Professional | | $7.08 | $14.45 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.47 / $10.47
| Facility | | $7.41 | $10.47 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $11.22 / $20.42
| Professional | | $7.41 | $11.22 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $12.88 / $10,000.00
| Facility | | $7.08 | $12.88 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $12.88 / $10,000.00
| Professional | | $7.08 | $12.88 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $9.77 / $14.79
| Facility | | $4.07 | $9.77 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.25 / $9.77
| Professional | | $4.07 | $5.25 | $9.77 |