- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $14.13 / $100.00
| Facility | | $4.79 | $14.13 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.07 / $8.13
| Professional | | $3.98 | $4.07 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $8.32 / $25.12
| Facility | | $4.17 | $8.32 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.37 / $6.76
| Professional | | $3.89 | $4.37 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $9.12
| Facility | | $9.12 | $9.12 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $5.13
| Facility | | $3.47 | $3.47 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $7.94
| Professional | | $3.47 | $3.47 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $8.13 / $12.59
| Facility | | $7.24 | $8.13 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $3.89 / $6.92
| Professional | | $3.89 | $3.89 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.07 / $19.95
| Facility | | $3.89 | $4.07 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.07 / $7.24
| Professional | | $4.07 | $4.07 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.27 / $5.37
| Professional | | $3.47 | $4.27 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.79 / $7.41
| Professional | | $3.63 | $4.79 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $9.77 / $9.77
| Facility | | $5.50 | $9.77 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.37 / $7.08
| Professional | | $3.89 | $4.37 | $7.08 |