- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $64.57 / $93.33
| Facility | | $8.32 | $64.57 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.94 / $8.91
| Professional | | $6.03 | $7.94 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $38.02
| Facility | | $8.91 | $8.91 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $6.76
| Professional | | $4.37 | $4.37 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $30.90 / $43.65
| Professional | | $18.20 | $30.90 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $22.91 / $39.81
| Facility | | $9.12 | $22.91 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $6.46 / $15.49
| Professional | | $4.79 | $6.46 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.72 / $13.18
| Professional | | $8.91 | $10.72 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $14.79 / $17.38
| Professional | | $7.24 | $14.79 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $14.45
| Facility | | $8.13 | $8.13 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $18.62
| Professional | | $11.75 | $11.75 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $14.79 / $10,000.00
| Facility | | $7.94 | $14.79 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $15.14 / $10,000.00
| Professional | | $7.94 | $15.14 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $8.91 / $15.14
| Facility | | $3.72 | $8.91 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.68 / $8.91
| Professional | | $3.63 | $4.68 | $8.91 |