- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $8.91 / $24.55
| Facility | | $4.17 | $8.91 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.69 / $3.31
| Professional | | $2.00 | $2.69 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $4.27 / $100.00
| Facility | | $2.75 | $4.27 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $3.02 / $7.41
| Professional | | $1.48 | $3.02 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.08 / $10.23
| Facility | | $5.75 | $7.08 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $2.82 / $3.72
| Professional | | $2.82 | $2.82 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $4.79 / $11.75
| Facility | | $2.34 | $4.79 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $3.31 / $8.13
| Professional | | $1.78 | $3.31 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $16.98 / $7,079.46
| Facility | | $3.09 | $16.98 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.17 / $4.90
| Professional | | $4.17 | $4.17 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $8.32
| Professional | | $3.02 | $3.02 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.80 / $15.85
| Facility | | $2.82 | $3.80 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $4.27 / $100.00
| Facility | | $2.75 | $4.27 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $3.02 / $7.41
| Professional | | $1.48 | $3.02 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.63 / $4.90
| Facility | | $2.63 | $3.63 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.02 / $4.57
| Professional | | $2.63 | $3.02 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $3.02 / $4.90
| Facility | | $1.74 | $3.02 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $2.45 / $8.13
| Professional | | $1.20 | $2.45 | $8.13 |