- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $45.71 / $87.10
| Facility | | $5.62 | $45.71 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.55 / $6.03
| Professional | | $2.00 | $3.55 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $16.98
| Facility | | $3.98 | $3.98 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $1.95 / $3.09
| Professional | | $1.95 | $1.95 | $3.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $19.05 / $28.18
| Professional | | $11.75 | $19.05 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $10.47 / $17.78
| Facility | | $4.07 | $10.47 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.88 / $6.92
| Professional | | $2.14 | $2.88 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.79 / $5.89
| Professional | | $3.98 | $4.79 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $6.76 / $7.76
| Professional | | $3.31 | $6.76 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $3.63 / $3.80
| Facility | | $3.55 | $3.63 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $5.01 / $8.32
| Professional | | $3.55 | $5.01 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $5.75 / $10,000.00
| Facility | | $3.09 | $5.75 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $5.62 / $10,000.00
| Professional | | $3.09 | $5.62 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $3.98 / $6.92
| Facility | | $1.70 | $3.98 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $2.40 / $4.37
| Professional | | $1.70 | $2.40 | $4.37 |