- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $20.89 / $30.20
| Facility | | $3.98 | $20.89 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $7.08 / $13.49
| Professional | | $3.98 | $7.08 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $10.72 / $79.43
| Facility | | $6.92 | $10.72 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $9.33 / $22.91
| Professional | | $4.37 | $9.33 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $18.62 / $26.92
| Facility | | $14.79 | $18.62 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $8.71 / $9.12
| Professional | | $6.46 | $8.71 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $10.23 / $19.50
| Facility | | $6.03 | $10.23 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $10.23 / $24.55
| Professional | | $3.89 | $10.23 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $38.90 / $7,079.46
| Facility | | $5.75 | $38.90 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $15.85
| Professional | | $13.49 | $13.49 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $9.33 / $20.42
| Professional | | $7.94 | $9.33 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $10.72 / $79.43
| Facility | | $6.92 | $10.72 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $9.33 / $22.91
| Professional | | $4.37 | $9.33 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $7.41 / $9.33
| Facility | | $3.47 | $7.41 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $9.33 / $23.99
| Professional | | $4.27 | $9.33 | $23.99 |