- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $53.70 / $407.38
| Facility | | $7.08 | $53.70 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.55 / $10.00
| Professional | | $3.02 | $3.55 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $11.22 / $14.13
| Facility | | $6.92 | $11.22 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $4.79 / $7.59
| Professional | | $2.63 | $4.79 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $9.33 / $10.96
| Professional | | $8.91 | $9.33 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $25.70 / $95.50
| Facility | | $4.27 | $25.70 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $5.13 / $7.08
| Professional | | $3.55 | $5.13 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $8.51
| Facility | | $4.27 | $4.27 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $8.71
| Professional | | $4.27 | $4.27 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $6.03 / $12.59
| Facility | | $3.89 | $6.03 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.13 / $79.43
| Professional | | $3.89 | $5.13 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $12.88 / $17.78
| Facility | | $6.46 | $12.88 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.98 / $5.13
| Professional | | $3.24 | $3.98 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $5.13 / $6.92
| Facility | | $2.45 | $5.13 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.24 / $6.31
| Professional | | $2.57 | $3.24 | $6.31 |