- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $11.75 / $28.18
| Facility | | $3.98 | $11.75 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $5.01
| Professional | | $3.98 | $3.98 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $24.55
| Facility | | $5.75 | $5.75 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.34 / $3.89
| Professional | | $2.34 | $2.34 | $3.89 |
- 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
- $5.89 / $12.30 / $26.92
| Facility | | $5.89 | $12.30 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $3.63 / $8.32
| Professional | | $2.88 | $3.63 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.92 / $8.51
| Professional | | $5.75 | $6.92 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $7.94 / $9.33
| Professional | | $3.98 | $7.94 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.17 / $7.59
| Facility | | $4.17 | $4.17 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $12.02
| Professional | | $6.17 | $6.17 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $7.59 / $10,000.00
| Facility | | $4.37 | $7.59 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $7.41 / $10,000.00
| Professional | | $4.37 | $7.41 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $5.75 / $8.13
| Facility | | $2.45 | $5.75 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $4.07 / $6.61
| Professional | | $3.16 | $4.07 | $6.61 |