- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $10.47 / $46.77
| Facility | | $3.72 | $10.47 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $7.76 / $16.60
| Professional | | $1.00 | $7.76 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $21.38 / $47.86
| Facility | | $18.62 | $21.38 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.89 / $4.17
| Professional | | $2.75 | $3.89 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $19.95
| Facility | | $19.95 | $19.95 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $4.79 / $6.03
| Professional | | $2.88 | $4.79 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $3.98 / $100.00
| Facility | | $1.51 | $3.98 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.51 / $2.82
| Professional | | $1.12 | $1.51 | $2.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.09 / $5.25
| Professional | | $3.09 | $3.09 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.09 / $3.09
| Facility | | $3.09 | $3.09 | $3.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $3.72 / $4.37
| Facility | | $3.72 | $3.72 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.51 / $3.39
| Facility | | $1.07 | $1.51 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $1.51 / $2.82
| Professional | | $1.45 | $1.51 | $2.82 |