- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $6.46 / $16.22
| Facility | | $2.57 | $6.46 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.00 / $3.09
| Professional | | $2.00 | $2.00 | $3.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.09 / $6.46
| Facility | | $2.75 | $3.09 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $2.63 / $5.13
| Professional | | $2.57 | $2.63 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.02 / $3.80
| Facility | | $2.63 | $3.02 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.31 / $6.46
| Professional | | $2.57 | $3.31 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $5.37 / $6.76
| Facility | | $2.69 | $5.37 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $2.69
| Professional | | $2.69 | $2.69 | $2.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.03 / $398.11
| Professional | | $3.98 | $6.03 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $100.00
| Facility | | $85.11 | $85.11 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.72 / $7.08
| Facility | | $2.69 | $3.72 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $2.69
| Professional | | $2.69 | $2.69 | $2.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.24 / $4.27
| Professional | | $2.51 | $3.24 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $6.76 / $6.76
| Facility | | $2.63 | $6.76 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $2.63 / $6.61
| Professional | | $2.63 | $2.63 | $6.61 |