- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $17.78 / $165.96
| Facility | | $7.08 | $17.78 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $7.76
| Professional | | $3.02 | $3.98 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $21.88
| Facility | | $5.13 | $5.13 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $2.57 / $3.98
| Professional | | $2.57 | $2.57 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $26.30 / $36.31
| Professional | | $15.49 | $26.30 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $13.49 / $23.99
| Facility | | $5.25 | $13.49 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.80 / $8.91
| Professional | | $2.82 | $3.80 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.17 / $7.59
| Professional | | $5.13 | $6.17 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $8.71 / $10.00
| Professional | | $4.27 | $8.71 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $8.32
| Facility | | $4.68 | $4.68 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $8.32 / $10.96
| Professional | | $5.13 | $8.32 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $7.59 / $10,000.00
| Facility | | $4.07 | $7.59 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $7.59 / $10,000.00
| Professional | | $4.07 | $7.59 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $5.13 / $10.47
| Facility | | $2.19 | $5.13 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.09 / $5.75
| Professional | | $2.19 | $3.09 | $5.75 |