- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $11.75 / $83.18
| Facility | | $3.98 | $11.75 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.89 / $6.76
| Professional | | $3.02 | $3.89 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $18.20
| Facility | | $4.27 | $4.27 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $2.57 / $3.24
| Professional | | $2.19 | $2.57 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $17.38 / $24.55
| Professional | | $10.23 | $17.38 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $10.96 / $19.50
| Facility | | $4.37 | $10.96 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $3.09 / $7.24
| Professional | | $2.29 | $3.09 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.13 / $6.31
| Professional | | $4.27 | $5.13 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $7.08 / $8.32
| Professional | | $3.55 | $7.08 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $3.89 / $4.57
| Facility | | $3.89 | $3.89 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $6.17 / $8.91
| Professional | | $4.57 | $6.17 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $5.62 / $10,000.00
| Facility | | $3.09 | $5.62 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $5.50 / $10,000.00
| Professional | | $3.09 | $5.50 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $4.27 / $7.41
| Facility | | $1.78 | $4.27 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.02 / $5.01
| Professional | | $2.51 | $3.02 | $5.01 |