- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $15.85 / $44.67
| Facility | | $5.01 | $15.85 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $7.24
| Professional | | $5.01 | $5.01 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $30.90
| Facility | | $7.24 | $7.24 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $3.55 / $5.50
| Professional | | $3.55 | $3.55 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $35.48 / $52.48
| Professional | | $22.39 | $35.48 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $19.05 / $32.36
| Facility | | $7.41 | $19.05 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.01 / $10.23
| Professional | | $3.89 | $5.01 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $8.71 / $10.72
| Professional | | $7.24 | $8.71 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $12.59 / $14.79
| Professional | | $6.17 | $12.59 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.76 / $7.76
| Facility | | $6.46 | $7.76 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $6.46 / $15.14
| Professional | | $3.02 | $6.46 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $10.96 / $10,000.00
| Facility | | $5.62 | $10.96 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $10.47 / $10,000.00
| Professional | | $5.62 | $10.47 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $7.24 / $12.88
| Facility | | $3.02 | $7.24 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.37 / $7.94
| Professional | | $3.02 | $4.37 | $7.94 |