- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $9.33 / $25.12
| Facility | | $3.02 | $9.33 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $3.98
| Professional | | $3.02 | $3.02 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.17 / $17.78
| Facility | | $4.17 | $4.17 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.04 / $3.24
| Professional | | $2.04 | $2.04 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $19.95 / $29.51
| Professional | | $12.59 | $19.95 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $10.96 / $19.50
| Facility | | $4.27 | $10.96 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $3.02 / $7.24
| Professional | | $2.29 | $3.02 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.01 / $6.17
| Professional | | $4.17 | $5.01 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $7.08 / $8.32
| Professional | | $3.47 | $7.08 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $4.57 / $4.57
| Facility | | $3.72 | $4.57 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $6.46 / $8.91
| Professional | | $3.72 | $6.46 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $6.03 / $10,000.00
| Facility | | $3.24 | $6.03 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $6.03 / $10,000.00
| Professional | | $3.24 | $6.03 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $4.17 / $7.24
| Facility | | $1.78 | $4.17 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $2.51 / $4.57
| Professional | | $1.78 | $2.51 | $4.57 |