- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $69.18 / $177.83
| Facility | | $7.41 | $69.18 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $10.00
| Professional | | $3.02 | $3.98 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.63 / $5.75
| Professional | | $2.82 | $3.63 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $15.14 / $30.20
| Facility | | $5.13 | $15.14 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.07 / $5.62
| Professional | | $3.80 | $4.07 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $9.12 / $57.54
| Facility | | $5.37 | $9.12 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $5.75 / $10.00
| Professional | | $3.63 | $5.75 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $17.38 / $17.38
| Facility | | $5.75 | $17.38 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $10.96 / $25.70
| Facility | | $5.01 | $10.96 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $4.68 / $8.71
| Professional | | $2.82 | $4.68 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $100.00
| Facility | | $60.26 | $60.26 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $9.33
| Professional | | $9.33 | $9.33 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $10.96 / $125.89
| Facility | | $4.27 | $10.96 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.01 / $10.96
| Professional | | $3.02 | $5.01 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.90 / $4.90
| Professional | | $4.37 | $4.90 | $4.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $977.24 / $1,202.26
| Facility | | $691.83 | $977.24 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.75 / $16.22
| Facility | | $4.27 | $5.75 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $4.68 / $7.59
| Professional | | $2.82 | $4.68 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $5.75 / $6.92
| Facility | | $2.45 | $5.75 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.47 / $6.03
| Professional | | $3.16 | $3.47 | $6.03 |