- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $15.14 / $24.55
| Facility | | $5.01 | $15.14 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $7.94
| Professional | | $5.01 | $6.03 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $33.88
| Facility | | $7.94 | $7.94 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $3.98 / $5.89
| Professional | | $3.89 | $3.98 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $13.80 / $20.42
| Professional | | $8.51 | $13.80 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $18.20 / $35.48
| Facility | | $8.13 | $18.20 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $5.89 / $13.80
| Professional | | $4.47 | $5.89 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $9.55 / $11.75
| Professional | | $7.94 | $9.55 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $13.49 / $15.49
| Professional | | $6.61 | $13.49 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $8.71 / $8.71
| Facility | | $7.59 | $8.71 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $8.32 / $16.60
| Professional | | $4.90 | $8.32 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $10.96 / $10,000.00
| Facility | | $4.90 | $10.96 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $10.96 / $10,000.00
| Professional | | $4.90 | $10.96 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $7.94 / $13.80
| Facility | | $3.39 | $7.94 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $3.55 / $6.46
| Professional | | $1.70 | $3.55 | $6.46 |