- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $21.88 / $45.71
| Facility | | $7.08 | $21.88 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $8.91
| Professional | | $7.08 | $7.08 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $41.69
| Facility | | $10.00 | $10.00 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $6.61
| Professional | | $3.98 | $3.98 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $35.48 / $53.70
| Professional | | $22.39 | $35.48 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $19.50 / $44.67
| Facility | | $10.00 | $19.50 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $6.03 / $11.48
| Professional | | $4.90 | $6.03 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.02 / $14.79
| Professional | | $10.00 | $12.02 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $12.88 / $14.79
| Professional | | $5.89 | $12.88 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.24 / $8.51
| Facility | | $6.46 | $7.24 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.94 / $20.89
| Professional | | $6.46 | $7.94 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $12.30 / $10,000.00
| Facility | | $7.24 | $12.30 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $12.88 / $10,000.00
| Professional | | $7.24 | $12.88 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $10.00 / $13.18
| Facility | | $4.17 | $10.00 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.01 / $8.32
| Professional | | $4.17 | $5.01 | $8.32 |