- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $26.30 / $47.86
| Facility | | $8.91 | $26.30 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $38.90
| Professional | | $3.98 | $3.98 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $15.85 / $16.22
| Facility | | $12.59 | $15.85 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.34 / $21.88
| Professional | | $2.34 | $2.34 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $3.63 / $3.63
| Facility | | $3.63 | $3.63 | $3.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $19.05 / $30.20
| Facility | | $16.22 | $19.05 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $8.32 / $18.20
| Professional | | $6.61 | $8.32 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $11.75 / $34.67
| Facility | | $3.89 | $11.75 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.25 / $100.00
| Facility | | $3.89 | $5.25 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.63 / $10.72
| Professional | | $3.16 | $3.63 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $8.91 / $64.57
| Professional | | $2.95 | $8.91 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $7.08 / $12.30
| Facility | | $6.61 | $7.08 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $8.32 / $16.60
| Professional | | $4.37 | $8.32 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $15.14 / $87.10
| Professional | | $7.94 | $15.14 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $100.00
| Facility | | $11.75 | $11.75 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $2.88 / $4.17
| Professional | | $2.75 | $2.88 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $12.59
| Professional | | $8.32 | $8.32 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $21.88 / $32.36
| Professional | | $8.32 | $21.88 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $4.68 / $12.88
| Facility | | $2.95 | $4.68 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.98 / $10.72
| Professional | | $2.51 | $3.98 | $10.72 |