- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $26.30 / $151.36
| Facility | | $7.08 | $26.30 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.92 / $14.45
| Professional | | $4.47 | $6.92 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $33.11
| Facility | | $7.76 | $7.76 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $5.89
| Professional | | $3.80 | $3.80 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $38.90 / $53.70
| Professional | | $22.91 | $38.90 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $19.50 / $35.48
| Facility | | $7.76 | $19.50 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.62 / $13.18
| Professional | | $4.27 | $5.62 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $9.33 / $11.48
| Professional | | $7.76 | $9.33 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $12.88 / $15.14
| Professional | | $5.89 | $12.88 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $12.30
| Facility | | $6.92 | $6.92 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $12.88 / $16.22
| Professional | | $12.88 | $12.88 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $11.22 / $10,000.00
| Facility | | $6.03 | $11.22 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $10.96 / $10,000.00
| Professional | | $6.03 | $10.96 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $7.76 / $13.18
| Facility | | $3.24 | $7.76 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.68 / $8.32
| Professional | | $3.24 | $4.68 | $8.32 |