- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $812.83 / $8,511.38
| Facility | | $6.03 | $812.83 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $27.54 / $112.20
| Professional | | $5.62 | $27.54 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $8.32 / $11.22
| Professional | | $1.51 | $8.32 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,621.81 / $3,162.28
| Facility | | $1,258.93 | $1,621.81 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $5.50 / $12.88
| Professional | | $2.40 | $5.50 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $7.24 / $15.85
| Professional | | $4.57 | $7.24 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $10.72 / $1,230.27
| Facility | | $3.47 | $10.72 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $13.80 / $67.61
| Professional | | $7.59 | $13.80 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $12.59 / $16.22
| Professional | | $4.68 | $12.59 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.61 / $15.14
| Professional | | $4.68 | $6.61 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,548.82 / $4,466.84
| Facility | | $1,096.48 | $1,548.82 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $7.24 / $15.85
| Professional | | $2.95 | $7.24 | $15.85 |