- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $43.65 / $81.28
| Facility | | $7.08 | $43.65 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.37 / $6.03
| Professional | | $3.02 | $4.37 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $21.38
| Facility | | $5.01 | $5.01 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $2.40 / $3.89
| Professional | | $2.40 | $2.40 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $21.88 / $33.11
| Professional | | $13.80 | $21.88 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $12.59 / $22.39
| Facility | | $5.13 | $12.59 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.55 / $8.51
| Professional | | $2.69 | $3.55 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $7.41
| Professional | | $5.01 | $6.03 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.13 / $9.55
| Professional | | $4.07 | $8.13 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.37 / $4.57
| Facility | | $4.17 | $4.37 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.68 / $10.72
| Professional | | $4.17 | $4.68 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $8.13 / $10,000.00
| Facility | | $4.37 | $8.13 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $8.32 / $10,000.00
| Professional | | $4.37 | $8.32 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $5.01 / $8.32
| Facility | | $2.14 | $5.01 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.88 / $5.01
| Professional | | $2.14 | $2.88 | $5.01 |