- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $17.78 / $57.54
| Facility | | $6.31 | $17.78 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $11.22 / $26.92
| Professional | | $2.82 | $11.22 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $9.12 / $10.72
| Professional | | $6.46 | $9.12 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $32.36 / $70.79
| Facility | | $28.18 | $32.36 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $6.61 / $7.08
| Professional | | $4.57 | $6.61 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $14.13
| Facility | | $14.13 | $14.13 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $8.32 / $10.23
| Professional | | $5.01 | $8.32 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $14.45 / $100.00
| Facility | | $2.57 | $14.45 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $4.27 / $6.17
| Professional | | $2.57 | $4.27 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $8.71
| Professional | | $5.25 | $5.25 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $5.25
| Facility | | $5.25 | $5.25 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $2.57 / $5.75
| Facility | | $1.78 | $2.57 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $4.27 / $6.17
| Professional | | $2.57 | $4.27 | $6.17 |