- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $17.78 / $28.84
| Facility | | $6.03 | $17.78 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $13.80
| Professional | | $5.01 | $6.03 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $9.55 / $100.00
| Facility | | $6.31 | $9.55 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $6.92 / $16.60
| Professional | | $4.07 | $6.92 | $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 / $10.96 / $26.30
| Facility | | $5.37 | $10.96 | $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 / $45.71 / $7,079.46
| Facility | | $7.76 | $45.71 | $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
- $6.92 / $6.92 / $18.62
| Professional | | $6.92 | $6.92 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $9.55 / $100.00
| Facility | | $6.31 | $9.55 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $6.92 / $16.60
| Professional | | $4.07 | $6.92 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $6.92 / $11.22
| Facility | | $3.89 | $6.92 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $6.92 / $17.38
| Professional | | $4.07 | $6.92 | $17.38 |