- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $10.00 / $23.44
| Facility | | $3.02 | $10.00 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $7.41
| Professional | | $3.02 | $3.02 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $5.25 / $100.00
| Facility | | $3.39 | $5.25 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.47 / $10.96
| Professional | | $2.69 | $4.47 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.33 / $13.49
| Facility | | $7.41 | $9.33 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $4.79
| Professional | | $4.27 | $4.27 | $4.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $6.17 / $14.45
| Facility | | $3.16 | $6.17 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $5.25 / $11.75
| Professional | | $2.69 | $5.25 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $19.50 / $7,079.46
| Facility | | $3.55 | $19.50 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $7.76
| Professional | | $6.46 | $6.46 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.47 / $10.96
| Professional | | $4.47 | $4.47 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $5.25 / $100.00
| Facility | | $3.39 | $5.25 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.47 / $10.96
| Professional | | $2.69 | $4.47 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $4.47 / $5.50
| Facility | | $2.14 | $4.47 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $4.47 / $10.96
| Professional | | $2.51 | $4.47 | $10.96 |