- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $37.15 / $812.83
| Facility | | $6.61 | $37.15 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $13.80
| Professional | | $3.02 | $3.98 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.88 / $13.18
| Facility | | $10.23 | $12.88 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.34 / $19.05
| Professional | | $2.34 | $2.34 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $3.63 / $3.63
| Facility | | $3.63 | $3.63 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $4.79 / $4.79
| Professional | | $4.79 | $4.79 | $4.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $15.85 / $25.12
| Facility | | $13.49 | $15.85 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.24 / $14.79
| Professional | | $5.75 | $7.24 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $10.47 / $38.02
| Facility | | $4.27 | $10.47 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.57 / $66.07
| Facility | | $3.80 | $4.57 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.98 / $10.72
| Professional | | $2.82 | $3.98 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $16.60 / $64.57
| Professional | | $4.07 | $16.60 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $13.49
| Facility | | $5.75 | $5.75 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $7.76 / $13.49
| Professional | | $3.55 | $7.76 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $12.02 / $48.98
| Professional | | $6.17 | $12.02 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $9.55 / $100.00
| Facility | | $9.55 | $9.55 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.09 / $4.68
| Professional | | $2.51 | $3.09 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $11.22
| Professional | | $10.00 | $10.00 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $23.99 / $29.51
| Professional | | $11.22 | $23.99 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $4.27 / $5.75
| Facility | | $2.40 | $4.27 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $3.80 / $10.72
| Professional | | $2.40 | $3.80 | $10.72 |