- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $52.48 / $138.04
| Facility | | $9.12 | $52.48 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.13 / $9.33
| Professional | | $7.08 | $8.13 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $39.81
| Facility | | $9.33 | $9.33 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $4.68 / $6.92
| Professional | | $4.57 | $4.68 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $47.86 / $66.07
| Professional | | $28.18 | $47.86 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $23.99 / $42.66
| Facility | | $9.55 | $23.99 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.92 / $16.22
| Professional | | $5.13 | $6.92 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $11.22 / $14.13
| Professional | | $9.33 | $11.22 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $15.85 / $18.62
| Professional | | $7.76 | $15.85 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $15.14
| Facility | | $8.13 | $8.13 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $19.95
| Professional | | $12.02 | $12.02 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $13.18 / $10,000.00
| Facility | | $5.75 | $13.18 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $13.18 / $10,000.00
| Professional | | $6.17 | $13.18 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $9.33 / $16.22
| Facility | | $3.98 | $9.33 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.62 / $9.33
| Professional | | $3.98 | $5.62 | $9.33 |