- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $3,235.94 / $8,317.64
| Facility | | $6.03 | $3,235.94 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $6.03 / $10.00
| Professional | | $2.00 | $6.03 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $18.62
| Facility | | $9.33 | $9.33 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $1.20 / $5.37
| Professional | | $1.20 | $1.20 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $10.96 / $15.14
| Professional | | $6.31 | $10.96 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $6.76 / $39.81
| Facility | | $4.90 | $6.76 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.26 / $2.24
| Professional | | $1.26 | $1.26 | $2.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $11.22 / $13.80
| Professional | | $9.33 | $11.22 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $3.02 / $4.17
| Professional | | $1.82 | $3.02 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.62 / $9.33
| Facility | | $5.37 | $5.62 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $5.62
| Professional | | $5.62 | $5.62 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $3.55 / $10,000.00
| Facility | | $2.09 | $3.55 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $3.55 / $10,000.00
| Professional | | $2.09 | $3.55 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $3.02 / $3.72
| Facility | | $1.82 | $3.02 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.51 / $3.89
| Professional | | $1.26 | $1.51 | $3.89 |