- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $25.12 / $50.12
| Facility | | $8.91 | $25.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.01 / $34.67
| Professional | | $3.02 | $5.01 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $13.80 / $29.51
| Facility | | $2.75 | $13.80 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $5.37 / $14.45
| Professional | | $2.34 | $5.37 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $35.48 / $72.44
| Facility | | $11.48 | $35.48 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.90 / $15.49
| Professional | | $3.47 | $4.90 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $10.23 / $19.95
| Facility | | $4.07 | $10.23 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $5.75 / $11.75
| Professional | | $3.09 | $5.75 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $5.89 / $9.33
| Professional | | $4.68 | $5.89 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $5.89 / $13.18
| Professional | | $4.68 | $5.89 | $13.18 |
- 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
- $2.95 / $2.95 / $5.89
| Professional | | $2.95 | $2.95 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $6.76 / $16.22
| Facility | | $4.27 | $6.76 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.98 / $11.75
| Professional | | $3.09 | $3.98 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $20.42
| Professional | | $20.42 | $20.42 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.03 / $10.00
| Professional | | $4.68 | $6.03 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.55 / $7.08
| Facility | | $2.63 | $3.55 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $3.55 / $11.22
| Professional | | $2.45 | $3.55 | $11.22 |