- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $28.84 / $57.54
| Facility | | $4.79 | $28.84 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $4.79 / $20.89
| Professional | | $2.24 | $4.79 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.33 / $9.55
| Facility | | $7.41 | $9.33 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.09 / $12.30
| Professional | | $2.09 | $2.09 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.04 / $3.63
| Facility | | $2.04 | $2.04 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $3.47
| Professional | | $3.47 | $3.47 | $3.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $11.48 / $18.62
| Facility | | $10.00 | $11.48 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.37 / $12.30
| Professional | | $4.17 | $5.37 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $6.92 / $20.42
| Facility | | $2.29 | $6.92 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $3.47 / $83.18
| Facility | | $2.29 | $3.47 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $3.47 / $6.46
| Professional | | $2.09 | $3.47 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $8.91 / $64.57
| Professional | | $3.47 | $8.91 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.17 / $7.24
| Facility | | $3.98 | $4.17 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $4.90 / $9.77
| Professional | | $2.63 | $4.90 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $8.51 / $24.55
| Professional | | $4.47 | $8.51 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $100.00
| Facility | | $6.92 | $6.92 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $1.70 / $2.63
| Professional | | $1.62 | $1.70 | $2.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $7.41
| Professional | | $7.24 | $7.24 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $9.77 / $19.05
| Professional | | $7.24 | $9.77 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $2.75 / $4.17
| Facility | | $1.74 | $2.75 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $3.47 / $10.72
| Professional | | $2.09 | $3.47 | $10.72 |