- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.96 / $34.67
| Facility | | $8.51 | $10.96 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.31 / $1,584.89
| Professional | | $5.01 | $6.31 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.92 / $12.88
| Facility | | $5.75 | $6.92 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $6.17 / $14.13
| Professional | | $5.25 | $6.17 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $6.17 / $11.22
| Facility | | $5.25 | $6.17 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $6.92 / $16.22
| Professional | | $5.37 | $6.92 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $9.12 / $12.30
| Facility | | $5.50 | $9.12 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $5.50
| Professional | | $5.25 | $5.25 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $5.75 / $12.02
| Professional | | $4.68 | $5.75 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $100.00
| Facility | | $85.11 | $85.11 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $5.37
| Professional | | $5.37 | $5.37 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $7.94 / $13.18
| Facility | | $5.25 | $7.94 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $9.77
| Professional | | $5.25 | $5.25 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $8.91
| Professional | | $8.91 | $8.91 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.75 / $8.91
| Professional | | $4.27 | $5.75 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $16.98 / $16.98
| Facility | | $5.25 | $16.98 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $12.59
| Professional | | $5.25 | $5.25 | $12.59 |