- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $66.07 / $288.40
| Facility | | $10.72 | $66.07 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.41 / $15.85
| Professional | | $6.03 | $7.41 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $35.48
| Facility | | $8.32 | $8.32 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.17 / $6.46
| Professional | | $4.17 | $4.17 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $42.66 / $58.88
| Professional | | $25.12 | $42.66 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $21.38 / $38.90
| Facility | | $8.51 | $21.38 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $6.03 / $14.45
| Professional | | $4.57 | $6.03 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.00 / $12.59
| Professional | | $8.32 | $10.00 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $14.13 / $16.60
| Professional | | $6.92 | $14.13 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $13.49
| Facility | | $7.59 | $7.59 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $17.78
| Professional | | $12.02 | $12.02 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $14.45 / $10,000.00
| Facility | | $7.41 | $14.45 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $14.45 / $10,000.00
| Professional | | $7.41 | $14.45 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $8.32 / $14.45
| Facility | | $3.55 | $8.32 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $5.01 / $8.71
| Professional | | $3.55 | $5.01 | $8.71 |