- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $53.70 / $100.00
| Facility | | $7.94 | $53.70 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.24 / $9.77
| Professional | | $6.03 | $7.24 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.37 / $5.62
| Professional | | $5.01 | $5.37 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $12.02 / $16.22
| Facility | | $8.51 | $12.02 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.24 / $8.13
| Professional | | $6.03 | $7.24 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $17.78 / $28.84
| Facility | | $8.51 | $17.78 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $8.71 / $12.88
| Professional | | $5.13 | $8.71 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $7.08 / $8.51
| Professional | | $5.13 | $7.08 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $16.22
| Facility | | $8.13 | $8.13 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $9.77
| Professional | | $8.13 | $8.13 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $13.18 / $22.39
| Facility | | $8.13 | $13.18 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $9.77
| Professional | | $7.24 | $7.24 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $12.02 / $21.38
| Facility | | $9.33 | $12.02 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.24 / $8.13
| Professional | | $6.03 | $7.24 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $9.77 / $9.77
| Facility | | $7.24 | $9.77 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $4.68 / $10.23
| Professional | | $3.39 | $4.68 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.17 / $14.45
| Professional | | $3.63 | $4.17 | $14.45 |