- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $10.00 / $12.30
| Facility | | $5.01 | $10.00 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $5.01
| Professional | | $3.02 | $3.02 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $12.02 / $12.30
| Facility | | $9.55 | $12.02 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.82 / $15.85
| Professional | | $1.82 | $1.82 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $3.02
| Facility | | $3.02 | $3.02 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $14.79 / $23.44
| Facility | | $12.59 | $14.79 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $6.76 / $14.13
| Professional | | $5.37 | $6.76 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $8.91 / $15.49
| Facility | | $3.31 | $8.91 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.98 / $100.00
| Facility | | $3.31 | $3.98 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $2.69 / $8.13
| Professional | | $1.62 | $2.69 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $32.36 / $85.11
| Professional | | $2.63 | $32.36 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.37 / $6.92
| Facility | | $4.79 | $5.37 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $4.57 / $12.59
| Professional | | $3.39 | $4.57 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $10.96 / $43.65
| Professional | | $5.75 | $10.96 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $100.00 / $100.00
| Facility | | $8.91 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $2.45 / $3.63
| Professional | | $2.40 | $2.45 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.00 / $9.55
| Professional | | $2.00 | $2.00 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $13.18 / $24.55
| Professional | | $2.00 | $13.18 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.63 / $5.37
| Facility | | $2.24 | $3.63 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $2.69 / $7.41
| Professional | | $1.62 | $2.69 | $7.41 |