- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $17.78 / $89.13
| Facility | | $6.03 | $17.78 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $8.13
| Professional | | $6.03 | $6.03 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $34.67
| Facility | | $8.13 | $8.13 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $5.75
| Professional | | $3.47 | $3.47 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $33.11 / $48.98
| Professional | | $20.89 | $33.11 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $18.62 / $37.15
| Facility | | $8.32 | $18.62 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.25 / $12.02
| Professional | | $3.89 | $5.25 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $9.77 / $12.02
| Professional | | $8.13 | $9.77 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $11.75 / $13.80
| Professional | | $5.75 | $11.75 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.31 / $6.92
| Facility | | $6.03 | $6.31 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $12.88 / $16.98
| Professional | | $6.03 | $12.88 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $10.96 / $10,000.00
| Facility | | $5.89 | $10.96 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $10.72 / $10,000.00
| Professional | | $5.89 | $10.72 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $8.13 / $12.02
| Facility | | $3.39 | $8.13 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $4.27 / $8.13
| Professional | | $3.39 | $4.27 | $8.13 |