- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $93.33 / $407.38
| Facility | | $25.70 | $93.33 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $16.60
| Professional | | $3.02 | $3.98 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $11.48 / $11.75
| Facility | | $9.12 | $11.48 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.09 / $16.98
| Professional | | $2.09 | $2.09 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $2.63 / $4.47
| Facility | | $2.63 | $2.63 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $4.27
| Professional | | $4.27 | $4.27 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $13.80 / $21.88
| Facility | | $11.75 | $13.80 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.17 / $13.49
| Professional | | $5.01 | $6.17 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $9.33 / $33.88
| Facility | | $3.80 | $9.33 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $5.13 / $81.28
| Facility | | $3.55 | $5.13 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.55 / $10.47
| Professional | | $2.51 | $3.55 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $32.36 / $85.11
| Professional | | $4.27 | $32.36 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $12.30
| Facility | | $5.13 | $5.13 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $7.08 / $12.02
| Professional | | $3.24 | $7.08 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $10.96 / $34.67
| Professional | | $5.75 | $10.96 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.51 / $100.00
| Facility | | $8.51 | $8.51 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $2.75 / $4.17
| Professional | | $2.29 | $2.75 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $9.12
| Professional | | $4.37 | $4.37 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $23.44
| Professional | | $4.37 | $4.37 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $3.80 / $10.23
| Facility | | $2.14 | $3.80 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.39 / $10.47
| Professional | | $2.00 | $3.39 | $10.47 |