- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $18.20 / $34.67
| Facility | | $6.03 | $18.20 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $13.49
| Professional | | $5.01 | $6.03 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $9.55 / $100.00
| Facility | | $6.17 | $9.55 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $6.76 / $16.60
| Professional | | $3.39 | $6.76 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $16.60 / $23.99
| Facility | | $13.18 | $16.60 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $8.71
| Professional | | $6.46 | $6.46 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $10.72 / $26.30
| Facility | | $5.37 | $10.72 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $7.76 / $18.20
| Professional | | $4.17 | $7.76 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $47.86 / $7,079.46
| Facility | | $7.76 | $47.86 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $11.48
| Professional | | $9.77 | $9.77 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $18.62
| Professional | | $6.76 | $6.76 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $9.55 / $100.00
| Facility | | $6.17 | $9.55 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $6.76 / $16.60
| Professional | | $3.39 | $6.76 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $6.76 / $11.22
| Facility | | $3.89 | $6.76 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $5.75 / $18.62
| Professional | | $2.75 | $5.75 | $18.62 |