- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $79.43 / $218.78
| Facility | | $12.88 | $79.43 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.59 / $16.98
| Professional | | $7.08 | $7.59 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $41.69
| Facility | | $9.77 | $9.77 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.17 / $7.08
| Professional | | $4.17 | $4.17 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $39.81 / $60.26
| Professional | | $25.12 | $39.81 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $22.39 / $44.67
| Facility | | $10.00 | $22.39 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $6.31 / $14.45
| Professional | | $4.79 | $6.31 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $11.75 / $14.45
| Professional | | $9.77 | $11.75 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $14.13 / $16.60
| Professional | | $7.08 | $14.13 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.76 / $8.32
| Facility | | $7.59 | $7.76 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $14.13 / $20.42
| Professional | | $7.59 | $14.13 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $14.13 / $10,000.00
| Facility | | $7.76 | $14.13 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $14.45 / $10,000.00
| Professional | | $7.76 | $14.45 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $9.77 / $14.45
| Facility | | $4.07 | $9.77 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.25 / $9.77
| Professional | | $4.07 | $5.25 | $9.77 |