- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $9.12 / $43.65
| Facility | | $3.31 | $9.12 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.51 / $13.49
| Professional | | $2.00 | $2.51 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $12.59 / $100.00
| Facility | | $8.32 | $12.59 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.82 / $125.89
| Professional | | $2.51 | $2.82 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $6.61
| Facility | | $3.31 | $3.31 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $5.50 / $6.03
| Professional | | $3.31 | $5.50 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $6.92 / $14.45
| Facility | | $4.27 | $6.92 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $3.31
| Professional | | $3.31 | $3.31 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $4.57 / $5,888.44
| Facility | | $3.31 | $4.57 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $3.31
| Professional | | $3.31 | $3.31 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $4.27 / $30.90
| Facility | | $2.45 | $4.27 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $12.59 / $100.00
| Facility | | $8.32 | $12.59 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.82 / $125.89
| Professional | | $2.51 | $2.82 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $1.95 / $2.51
| Facility | | $1.95 | $1.95 | $2.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.79 / $6.31
| Facility | | $3.09 | $4.79 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.31 / $4.27
| Professional | | $2.51 | $3.31 | $4.27 |