- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $26.92 / $1,737.80
| Facility | | $6.31 | $26.92 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.01 / $9.33
| Professional | | $3.02 | $5.01 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $954.99 / $1,949.84
| Facility | | $562.34 | $954.99 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.75 / $6.31
| Professional | | $4.79 | $5.75 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $13.80 / $18.62
| Facility | | $4.90 | $13.80 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $6.61 / $9.33
| Professional | | $2.75 | $6.61 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $32.36 / $64.57
| Professional | | $4.90 | $32.36 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $6.31 / $12.59
| Facility | | $6.31 | $6.31 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $6.31 / $12.30
| Professional | | $6.31 | $6.31 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $10.23 / $21.38
| Facility | | $5.75 | $10.23 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $7.59
| Professional | | $5.75 | $5.75 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $954.99 / $1,949.84
| Facility | | $52.48 | $954.99 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.75 / $6.31
| Professional | | $4.79 | $5.75 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $1,230.27 / $2,041.74
| Facility | | $6.31 | $1,230.27 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $2.69 / $6.31
| Professional | | $2.19 | $2.69 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $3.31 / $11.48
| Professional | | $2.88 | $3.31 | $11.48 |