- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $14.79 / $27.54
| Facility | | $5.01 | $14.79 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $7.94
| Professional | | $5.01 | $6.03 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $33.11
| Facility | | $7.76 | $7.76 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $5.62
| Professional | | $3.80 | $3.80 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $36.31 / $53.70
| Professional | | $22.91 | $36.31 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $19.50 / $35.48
| Facility | | $7.76 | $19.50 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.13 / $11.48
| Professional | | $4.27 | $5.13 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $9.33 / $11.48
| Professional | | $7.76 | $9.33 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $12.88 / $15.14
| Professional | | $6.46 | $12.88 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $7.24
| Facility | | $6.76 | $6.76 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $11.22 / $16.22
| Professional | | $6.92 | $11.22 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $9.33 / $10,000.00
| Facility | | $6.03 | $9.33 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $9.33 / $10,000.00
| Professional | | $6.03 | $9.33 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $7.76 / $13.18
| Facility | | $3.24 | $7.76 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.47 / $8.13
| Professional | | $3.24 | $4.47 | $8.13 |