- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $12.30 / $60.26
| Facility | | $5.50 | $12.30 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.27 / $7.94
| Professional | | $3.98 | $4.27 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.76 / $100.00
| Facility | | $4.37 | $6.76 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $5.50 / $13.49
| Professional | | $3.16 | $5.50 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $11.48 / $16.60
| Facility | | $9.12 | $11.48 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $6.03
| Professional | | $5.13 | $5.13 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $7.59 / $18.20
| Facility | | $3.80 | $7.59 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $6.17 / $14.45
| Professional | | $3.31 | $6.17 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $28.18 / $7,079.46
| Facility | | $5.13 | $28.18 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $9.33
| Professional | | $7.94 | $7.94 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $13.49
| Professional | | $5.50 | $5.50 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $46.77
| Facility | | $6.17 | $6.17 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.76 / $100.00
| Facility | | $4.37 | $6.76 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $5.50 / $13.49
| Professional | | $3.16 | $5.50 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.13 / $8.32
| Professional | | $4.79 | $5.13 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $5.50 / $6.92
| Facility | | $2.69 | $5.50 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $4.17 / $13.49
| Professional | | $3.16 | $4.17 | $13.49 |