- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $21.38 / $57.54
| Facility | | $5.75 | $21.38 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.55 / $17.78
| Professional | | $3.02 | $3.55 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $5.62 / $100.00
| Facility | | $3.63 | $5.62 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $3.98 / $9.55
| Professional | | $2.09 | $3.98 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $14.45
| Facility | | $7.94 | $10.00 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.01 / $5.01
| Professional | | $3.89 | $5.01 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $6.31 / $15.14
| Facility | | $3.09 | $6.31 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $4.57 / $6.76
| Professional | | $2.63 | $4.57 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.50 / $4,897.79
| Facility | | $4.07 | $5.50 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.13 / $6.61
| Professional | | $4.37 | $5.13 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $12.02
| Professional | | $3.98 | $3.98 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $5.50 / $33.11
| Facility | | $4.68 | $5.50 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $5.62 / $100.00
| Facility | | $3.63 | $5.62 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $3.98 / $9.55
| Professional | | $2.09 | $3.98 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $5.50 / $10.00
| Facility | | $3.47 | $5.50 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.07 / $5.89
| Professional | | $3.47 | $4.07 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.98 / $6.46
| Facility | | $2.24 | $3.98 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $3.31 / $12.02
| Professional | | $2.09 | $3.31 | $12.02 |