- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $27.54 / $67.61
| Facility | | $8.91 | $27.54 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $11.22
| Professional | | $8.91 | $8.91 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $52.48
| Facility | | $12.30 | $12.30 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $9.33
| Professional | | $5.62 | $5.62 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $38.02 / $57.54
| Professional | | $23.99 | $38.02 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $26.92 / $56.23
| Facility | | $12.59 | $26.92 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $8.51 / $19.95
| Professional | | $6.17 | $8.51 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $14.79 / $18.20
| Professional | | $12.30 | $14.79 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $19.05 / $22.39
| Professional | | $8.51 | $19.05 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.23 / $10.96
| Facility | | $10.00 | $10.23 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $10.00 / $26.30
| Professional | | $6.46 | $10.00 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $16.98 / $10,000.00
| Facility | | $9.12 | $16.98 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $16.98 / $10,000.00
| Professional | | $9.12 | $16.98 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $12.30 / $19.50
| Facility | | $5.25 | $12.30 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $6.17 / $12.30
| Professional | | $4.79 | $6.17 | $12.30 |