- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $9.33 / $32.36
| Facility | | $3.02 | $9.33 | $32.36 |
- 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
- $4.27 / $4.27 / $18.20
| Facility | | $4.27 | $4.27 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.09 / $3.24
| Professional | | $2.09 | $2.09 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $27.54 / $38.02
| Professional | | $15.85 | $27.54 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $13.80 / $21.88
| Facility | | $4.37 | $13.80 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.51 / $4.17
| Professional | | $2.51 | $2.51 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.13 / $6.31
| Professional | | $4.27 | $5.13 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $7.59 / $10.47
| Professional | | $3.89 | $7.59 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.50 / $7.59
| Facility | | $4.27 | $5.50 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $8.91
| Professional | | $3.47 | $3.47 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $7.59 / $10,000.00
| Facility | | $3.31 | $7.59 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $7.59 / $10,000.00
| Professional | | $3.31 | $7.59 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $4.27 / $9.33
| Facility | | $1.78 | $4.27 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $4.47 / $7.59
| Professional | | $2.57 | $4.47 | $7.59 |