- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $46.77 / $851.14
| Facility | | $8.91 | $46.77 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $7.08 / $16.98
| Professional | | $2.69 | $7.08 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $5.01 / $8.32
| Professional | | $2.24 | $5.01 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $1.51 / $7.08
| Facility | | $1.20 | $1.51 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $3.02 / $6.92
| Professional | | $1.20 | $3.02 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $17.38 / $38.02
| Facility | | $5.62 | $17.38 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.75 / $7.59
| Professional | | $1.95 | $2.75 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $8.91 / $23.44
| Facility | | $2.51 | $8.91 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $3.80 / $5.62
| Professional | | $1.51 | $3.80 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $100.00
| Professional | | $9.33 | $9.33 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $9.33 / $19.95
| Professional | | $6.03 | $9.33 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.33 / $21.38
| Professional | | $7.41 | $9.33 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,288.25 / $1,288.25
| Facility | | $1,288.25 | $1,288.25 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $10.47 / $21.88
| Professional | | $6.31 | $10.47 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $13.18
| Professional | | $13.18 | $13.18 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $7.94 / $18.62
| Facility | | $2.63 | $7.94 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.07 / $9.33
| Professional | | $3.02 | $4.07 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $9.33
| Professional | | $9.33 | $9.33 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $9.33 / $19.95
| Facility | | $3.89 | $9.33 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $3.02 / $44.67
| Professional | | $1.26 | $3.02 | $44.67 |