- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $3,981.07 / $15,848.93
| Facility | | $100.00 | $3,981.07 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $37.15 / $100.00
| Professional | | $6.03 | $37.15 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $6.92 / $14.13
| Professional | | $5.25 | $6.92 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $4,466.84 / $12,882.50
| Facility | | $2,570.40 | $4,466.84 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $8.51 / $18.62
| Professional | | $4.17 | $8.51 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $1,047.13 / $2,089.30
| Facility | | $66.07 | $1,047.13 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $7.24 / $14.13
| Professional | | $4.37 | $7.24 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $10.00
| Facility | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $6.61 / $13.49
| Professional | | $2.51 | $6.61 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $6.03 / $10.23
| Professional | | $1.95 | $6.03 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $6.61 / $12.88
| Professional | | $1.74 | $6.61 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $2,041.74
| Facility | | $54.95 | $56.23 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $186.21 / $186.21
| Professional | | $8.71 | $186.21 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $9.12
| Professional | | $5.50 | $5.50 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $6.46 / $15.14
| Facility | | $1.82 | $6.46 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $6.61 / $15.14
| Professional | | $2.51 | $6.61 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $20.42
| Professional | | $7.08 | $7.08 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $8.32 / $12.88
| Professional | | $1.78 | $8.32 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,584.89 / $6,760.83
| Facility | | $588.84 | $1,584.89 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $5.50 / $12.30
| Professional | | $1.91 | $5.50 | $12.30 |