- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $14.13 / $104.71
| Facility | | $3.98 | $14.13 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $4.27
| Professional | | $3.02 | $3.02 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $19.95
| Facility | | $4.68 | $4.68 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $2.34 / $3.47
| Professional | | $2.29 | $2.34 | $3.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $23.99 / $33.11
| Professional | | $14.13 | $23.99 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $11.75 / $20.89
| Facility | | $4.79 | $11.75 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.39 / $8.13
| Professional | | $2.63 | $3.39 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $5.62 / $6.92
| Professional | | $4.68 | $5.62 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $7.94 / $9.33
| Professional | | $3.89 | $7.94 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $7.94
| Facility | | $4.27 | $4.27 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $10.00
| Professional | | $3.80 | $3.80 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $6.31 / $10,000.00
| Facility | | $2.63 | $6.31 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $6.31 / $10,000.00
| Professional | | $2.51 | $6.31 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $4.68 / $8.13
| Facility | | $2.00 | $4.68 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.75 / $4.68
| Professional | | $2.00 | $2.75 | $4.68 |