- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $31.62 / $100.00
| Facility | | $9.55 | $31.62 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.76 / $24.55
| Professional | | $5.01 | $6.76 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.57 / $12.02
| Professional | | $4.47 | $4.57 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $724.44 / $1,230.27
| Facility | | $15.85 | $724.44 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $4.90 / $5.13
| Professional | | $4.90 | $4.90 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $52.48 / $5,011.87
| Facility | | $39.81 | $52.48 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $5.89 / $24.55
| Professional | | $5.89 | $5.89 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $11.48 / $25.70
| Facility | | $5.37 | $11.48 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $8.71 / $13.80
| Professional | | $4.47 | $8.71 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $4.47 / $10.96
| Professional | | $2.04 | $4.47 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $7.59
| Facility | | $7.59 | $7.59 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $8.32 / $13.18
| Professional | | $7.41 | $8.32 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $23.44 / $48.98
| Facility | | $11.22 | $23.44 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.47 / $5.62
| Professional | | $4.47 | $4.47 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $724.44 / $1,230.27
| Facility | | $15.85 | $724.44 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $4.90 / $5.13
| Professional | | $4.90 | $4.90 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $16.22 / $64.57
| Facility | | $6.03 | $16.22 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.92 / $12.59
| Professional | | $5.01 | $6.92 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,148.15 / $1,445.44
| Facility | | $1,000.00 | $1,148.15 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $8.91
| Facility | | $5.75 | $5.75 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $10.72 / $41.69
| Professional | | $5.75 | $10.72 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $7.59 / $9.12
| Facility | | $4.17 | $7.59 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $5.01 / $13.18
| Professional | | $3.39 | $5.01 | $13.18 |