- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $10.96 / $30.20
| Facility | | $3.02 | $10.96 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $5.01
| Professional | | $3.02 | $3.02 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $4.90 / $20.89
| Facility | | $4.90 | $4.90 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $2.45 / $3.63
| Professional | | $2.45 | $2.45 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $25.70 / $35.48
| Professional | | $14.79 | $25.70 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $13.18 / $22.39
| Facility | | $5.01 | $13.18 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $2.95 / $4.68
| Professional | | $2.95 | $2.95 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $5.89 / $7.41
| Professional | | $4.90 | $5.89 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $7.08 / $9.77
| Professional | | $4.17 | $7.08 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $5.25 / $7.76
| Facility | | $4.90 | $5.25 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.07 / $10.47
| Professional | | $4.07 | $4.07 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.94 / $10,000.00
| Facility | | $5.01 | $7.94 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.94 / $10,000.00
| Professional | | $5.01 | $7.94 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $4.90 / $8.71
| Facility | | $2.09 | $4.90 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.95 / $5.50
| Professional | | $2.09 | $2.95 | $5.50 |