- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $28.18 / $60.26
| Facility | | $8.91 | $28.18 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $12.02
| Professional | | $8.91 | $8.91 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $53.70
| Facility | | $12.59 | $12.59 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.59 / $9.77
| Professional | | $6.46 | $7.59 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $46.77 / $70.79
| Professional | | $29.51 | $46.77 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $25.12 / $57.54
| Facility | | $12.88 | $25.12 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $7.59 / $17.78
| Professional | | $6.17 | $7.59 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $15.14 / $18.62
| Professional | | $12.59 | $15.14 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $16.98 / $19.50
| Professional | | $8.32 | $16.98 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $9.33 / $10.72
| Facility | | $8.32 | $9.33 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $12.02 / $26.92
| Professional | | $8.32 | $12.02 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $16.22 / $10,000.00
| Facility | | $9.33 | $16.22 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $16.60 / $10,000.00
| Professional | | $9.33 | $16.60 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $12.59 / $17.38
| Facility | | $5.37 | $12.59 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $8.71 / $14.13
| Professional | | $6.31 | $8.71 | $14.13 |