- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $691.83 / $1,000.00
| Facility | | $7.76 | $691.83 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.63 / $40.74
| Professional | | $2.19 | $3.63 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.85 / $19.05
| Professional | | $15.14 | $15.85 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.16 / $2,238.72
| Facility | | $0.16 | $0.16 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.00 / $2.00
| Professional | | $2.00 | $2.00 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.14 / $0.16 / $5,011.87
| Facility | | $0.14 | $0.16 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.15 / $0.15
| Professional | | $0.15 | $0.15 | $0.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.56 / $0.60
| Facility | | $0.16 | $0.56 | $0.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.16 / $0.17
| Professional | | $0.16 | $0.16 | $0.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $0.18 / $0.22
| Professional | | $0.17 | $0.18 | $0.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.16 / $0.16
| Facility | | $0.16 | $0.16 | $0.16 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.17 / $0.32 / $14.79
| Professional | | $0.17 | $0.32 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $58.88 / $109.65
| Facility | | $2.40 | $58.88 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.93 / $1.38 / $1.62
| Professional | | $0.93 | $1.38 | $1.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.16 / $0.16 / $0.19
| Facility | | $0.16 | $0.16 | $0.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.00 / $2.00
| Professional | | $2.00 | $2.00 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.55 / $19.05 / $32.36
| Facility | | $0.55 | $19.05 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $1.07 / $22.91
| Professional | | $1.00 | $1.07 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $1.10 / $30.20
| Professional | | $0.60 | $1.10 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.35 / $0.42
| Facility | | $0.21 | $0.35 | $0.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.21 / $0.35 / $0.42
| Professional | | $0.21 | $0.35 | $0.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.15 / $0.16 / $4.07
| Professional | | $0.15 | $0.16 | $4.07 |