- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $63.10 / $128.82
| Facility | | $8.51 | $63.10 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.89 / $9.77
| Professional | | $3.98 | $5.89 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $6.61 / $28.18
| Facility | | $6.61 | $6.61 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.24 / $5.13
| Professional | | $3.24 | $3.24 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $33.88 / $46.77
| Professional | | $19.50 | $33.88 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $16.60 / $29.51
| Facility | | $6.76 | $16.60 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $4.79 / $11.48
| Professional | | $3.55 | $4.79 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $7.94 / $9.77
| Professional | | $6.61 | $7.94 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $11.22 / $12.88
| Professional | | $5.50 | $11.22 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $7.08
| Facility | | $5.75 | $5.75 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.41 / $13.80
| Professional | | $7.08 | $7.41 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $10.96 / $10,000.00
| Facility | | $5.89 | $10.96 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $11.22 / $10,000.00
| Professional | | $5.89 | $11.22 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $6.61 / $11.48
| Facility | | $2.75 | $6.61 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.98 / $7.24
| Professional | | $2.75 | $3.98 | $7.24 |