- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $77.62 / $173.78
| Facility | | $14.13 | $77.62 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.76 / $9.77
| Professional | | $5.01 | $6.76 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $32.36
| Facility | | $7.59 | $7.59 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.47 / $5.75
| Professional | | $3.80 | $4.47 | $5.75 |
- 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
- $7.59 / $19.95 / $33.88
| Facility | | $7.59 | $19.95 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.61 / $12.88
| Professional | | $4.47 | $6.61 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $9.12 / $11.22
| Professional | | $7.59 | $9.12 | $11.22 |
- 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 / $6.61 / $7.59
| Facility | | $6.46 | $6.61 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $6.46 / $15.85
| Professional | | $5.62 | $6.46 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $12.30 / $10,000.00
| Facility | | $6.76 | $12.30 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $11.75 / $10,000.00
| Professional | | $6.76 | $11.75 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $7.59 / $12.88
| Facility | | $3.16 | $7.59 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $4.47 / $8.32
| Professional | | $3.16 | $4.47 | $8.32 |