- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $46.77 / $173.78
| Facility | | $6.17 | $46.77 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.68 / $8.91
| Professional | | $3.02 | $4.68 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.47 / $5.13
| Professional | | $2.51 | $3.47 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $16.60 / $30.20
| Facility | | $5.75 | $16.60 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $2.95 / $5.50
| Professional | | $2.82 | $2.95 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $7.76 / $41.69
| Facility | | $4.68 | $7.76 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $5.01 / $8.32
| Professional | | $3.09 | $5.01 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $5.13
| Facility | | $5.13 | $5.13 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $11.48 / $27.54
| Facility | | $6.03 | $11.48 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $5.50 / $10.23
| Professional | | $3.16 | $5.50 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $100.00
| Facility | | $60.26 | $60.26 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $7.59 / $8.51
| Professional | | $4.68 | $7.59 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $8.51 / $100.00
| Facility | | $3.98 | $8.51 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.68 / $9.33
| Professional | | $3.02 | $4.68 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.37 / $4.37
| Professional | | $3.89 | $4.37 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $3,311.31 / $3,311.31
| Facility | | $2,454.71 | $3,311.31 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.13 / $15.14
| Facility | | $4.17 | $5.13 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $5.13 / $8.51
| Professional | | $3.16 | $5.13 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $5.13 / $6.17
| Facility | | $2.19 | $5.13 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.02 / $5.37
| Professional | | $2.19 | $3.02 | $5.37 |