- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $57.54 / $416.87
| Facility | | $8.71 | $57.54 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $30.20
| Professional | | $6.03 | $7.08 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.01 / $5.13
| Professional | | $4.17 | $5.01 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $8.32 / $10.00
| Facility | | $7.41 | $8.32 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $8.32 / $12.30
| Professional | | $6.92 | $8.32 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $10.23 / $21.88
| Facility | | $5.89 | $10.23 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $8.71 / $16.98
| Professional | | $4.47 | $8.71 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $36.31 / $79.43
| Facility | | $8.32 | $36.31 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $11.75
| Professional | | $5.01 | $5.01 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $4.07 / $5.01
| Professional | | $1.00 | $4.07 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $6.92 / $10.47
| Facility | | $3.55 | $6.92 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $5.01 / $11.75
| Professional | | $3.55 | $5.01 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $8.32
| Professional | | $5.01 | $5.01 | $8.32 |