- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $30.20 / $100.00
| Facility | | $7.76 | $30.20 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.08 / $43.65
| Professional | | $5.75 | $7.08 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.37 / $12.88
| Professional | | $3.89 | $5.37 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $11.48 / $15.49
| Facility | | $8.13 | $11.48 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $6.92 / $7.76
| Professional | | $5.89 | $6.92 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $17.38 / $28.18
| Facility | | $8.13 | $17.38 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $8.32 / $12.30
| Professional | | $4.90 | $8.32 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.92 / $8.32
| Professional | | $5.01 | $6.92 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $15.49
| Facility | | $7.76 | $7.76 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $9.33
| Professional | | $7.76 | $7.76 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $13.49 / $21.38
| Facility | | $7.76 | $13.49 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $9.33
| Professional | | $6.92 | $6.92 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $11.75 / $20.42
| Facility | | $8.91 | $11.75 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $6.92 / $7.76
| Professional | | $5.89 | $6.92 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $9.33 / $9.33
| Facility | | $6.92 | $9.33 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.57 / $12.88
| Professional | | $3.24 | $4.57 | $12.88 |