- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $22.39 / $97.72
| Facility | | $5.50 | $22.39 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $11.22
| Professional | | $3.02 | $3.98 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.47 / $19.05
| Facility | | $4.47 | $4.47 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $2.19 / $3.47
| Professional | | $2.19 | $2.19 | $3.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $20.89 / $31.62
| Professional | | $13.18 | $20.89 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $11.75 / $20.89
| Facility | | $4.57 | $11.75 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.24 / $6.76
| Professional | | $2.51 | $3.24 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $5.37 / $6.61
| Professional | | $4.47 | $5.37 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $8.71
| Professional | | $7.59 | $7.59 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.07 / $4.27
| Facility | | $3.98 | $4.07 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.31 / $9.33
| Professional | | $3.98 | $6.31 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $6.46 / $10,000.00
| Facility | | $3.47 | $6.46 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $6.46 / $10,000.00
| Professional | | $3.47 | $6.46 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $4.47 / $7.76
| Facility | | $1.86 | $4.47 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.69 / $4.90
| Professional | | $1.86 | $2.69 | $4.90 |