- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $724.44 / $8,709.64
| Facility | | $14.79 | $724.44 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.14 / $2.14
| Professional | | $1.00 | $2.14 | $2.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $4.68 / $8.71
| Facility | | $1.86 | $4.68 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.54 / $0.54 / $0.54
| Professional | | $0.54 | $0.54 | $0.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.59 / $2.24 / $77.62
| Facility | | $0.59 | $2.24 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.28 / $0.68 / $1.78
| Facility | | $0.28 | $0.68 | $1.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $0.26 / $0.26
| Professional | | $0.26 | $0.26 | $0.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $194.98 / $8,709.64
| Facility | | $0.25 | $194.98 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $1.00 / $2.14
| Professional | | $0.26 | $1.00 | $2.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $0.25 / $0.26
| Professional | | $0.25 | $0.25 | $0.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,174.90 / $1,174.90
| Facility | | $1,174.90 | $1,174.90 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $0.37 / $1.10
| Facility | | $0.25 | $0.37 | $1.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $0.26 / $0.26
| Professional | | $0.26 | $0.26 | $0.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.34 / $0.46 / $0.46
| Facility | | $0.34 | $0.46 | $0.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.25 / $0.25 / $0.28
| Professional | | $0.25 | $0.25 | $0.28 |