- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $14.13 / $26.30
| Facility | | $5.01 | $14.13 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $5.01 / $6.03
| Professional | | $2.00 | $5.01 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $29.51
| Facility | | $7.08 | $7.08 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $4.17 / $5.25
| Professional | | $3.55 | $4.17 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $11.22 / $16.60
| Professional | | $7.08 | $11.22 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $9.12 / $30.90
| Facility | | $4.68 | $9.12 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $4.27 / $6.92
| Professional | | $1.78 | $4.27 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.32 / $10.47
| Professional | | $7.08 | $8.32 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $3.98 / $4.68
| Professional | | $1.95 | $3.98 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $5.13 / $5.89
| Facility | | $2.09 | $5.13 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $14.79 / $27.54
| Professional | | $2.09 | $14.79 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $8.32 / $10,000.00
| Facility | | $3.31 | $8.32 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $8.32 / $10,000.00
| Professional | | $3.24 | $8.32 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $7.08 / $8.32
| Facility | | $2.09 | $7.08 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.31 / $7.08
| Professional | | $2.00 | $3.31 | $7.08 |