- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $20.89 / $724.44
| Facility | | $4.47 | $20.89 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.02 / $64.57
| Professional | | $2.00 | $3.02 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $16.22
| Facility | | $3.80 | $3.80 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $1.91 / $2.95
| Professional | | $1.91 | $1.91 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $19.50 / $26.92
| Professional | | $11.22 | $19.50 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $9.77 / $17.78
| Facility | | $3.89 | $9.77 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.82 / $6.46
| Professional | | $2.14 | $2.82 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.57 / $5.62
| Professional | | $3.80 | $4.57 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $6.46 / $7.41
| Professional | | $3.16 | $6.46 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $6.17
| Facility | | $3.47 | $3.47 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $6.17 / $7.94
| Professional | | $3.63 | $6.17 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $5.50 / $10,000.00
| Facility | | $2.95 | $5.50 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $5.50 / $10,000.00
| Professional | | $2.95 | $5.50 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $3.80 / $7.76
| Facility | | $1.62 | $3.80 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $2.29 / $4.17
| Professional | | $1.62 | $2.29 | $4.17 |