- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $10.96 / $288.40
| Facility | | $4.79 | $10.96 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.39 / $25.12
| Professional | | $2.00 | $3.39 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $10.00 / $13.80
| Facility | | $6.17 | $10.00 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $4.37 / $7.24
| Professional | | $2.63 | $4.37 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $8.51 / $9.33
| Professional | | $7.59 | $8.51 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $17.38
| Facility | | $3.80 | $3.80 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.79 / $7.76
| Professional | | $3.80 | $4.79 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $7.94
| Facility | | $3.80 | $3.80 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $7.94
| Professional | | $3.80 | $3.80 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $5.50 / $11.75
| Facility | | $3.72 | $5.50 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.57 / $79.43
| Professional | | $3.80 | $4.57 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $1,122.02 / $1,380.38
| Facility | | $676.08 | $1,122.02 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $3.89 / $4.90
| Professional | | $2.88 | $3.89 | $4.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $1,096.48 / $1,778.28
| Facility | | $2.40 | $1,096.48 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $2.19 / $5.37
| Professional | | $1.62 | $2.19 | $5.37 |