- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $15.14 / $128.82
| Facility | | $5.75 | $15.14 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $8.71
| Professional | | $3.98 | $5.01 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $24.55
| Facility | | $5.75 | $5.75 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $2.82 / $4.27
| Professional | | $2.82 | $2.82 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $23.99 / $36.31
| Professional | | $15.14 | $23.99 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $14.79 / $26.92
| Facility | | $5.89 | $14.79 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.27 / $9.77
| Professional | | $3.24 | $4.27 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.92 / $8.51
| Professional | | $5.75 | $6.92 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $9.77 / $11.22
| Professional | | $4.79 | $9.77 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.25 / $5.50
| Facility | | $5.13 | $5.25 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $12.02 / $13.80
| Professional | | $5.13 | $12.02 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $7.08 / $10,000.00
| Facility | | $4.47 | $7.08 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $7.08 / $10,000.00
| Professional | | $4.47 | $7.08 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $5.75 / $10.00
| Facility | | $2.40 | $5.75 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $3.02 / $5.75
| Professional | | $2.40 | $3.02 | $5.75 |