- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $14.13 / $302.00
| Facility | | $6.46 | $14.13 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $15.85
| Professional | | $5.01 | $6.03 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $8.32 / $14.45
| Facility | | $7.24 | $8.32 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.98 / $8.91
| Professional | | $3.16 | $3.98 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $8.91
| Facility | | $6.03 | $6.03 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $7.76 / $10.47
| Professional | | $5.13 | $7.76 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $9.77 / $43.65
| Facility | | $5.13 | $9.77 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $4.27 / $11.75
| Professional | | $3.31 | $4.27 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.89 / $31.62
| Facility | | $5.13 | $5.89 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $3.47 / $8.32
| Professional | | $2.29 | $3.47 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $7.08 / $9.77
| Professional | | $5.89 | $7.08 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $9.33
| Facility | | $9.33 | $9.33 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $8.13 / $15.85
| Professional | | $5.50 | $8.13 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $7.76 / $11.75
| Facility | | $3.63 | $7.76 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.57 / $7.76
| Professional | | $3.09 | $4.57 | $7.76 |