- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $53.70 / $436.52
| Facility | | $7.41 | $53.70 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $14.13 / $302.00
| Professional | | $2.00 | $14.13 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $34.67 / $36.31
| Professional | | $34.67 | $34.67 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $48.98 / $123.03
| Facility | | $5.25 | $48.98 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $1.38 / $1.55
| Professional | | $1.38 | $1.38 | $1.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.87 / $1.23 / $1.58
| Facility | | $0.87 | $1.23 | $1.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.62 / $1.62
| Professional | | $0.62 | $0.62 | $1.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.36 / $12.02 / $79.43
| Professional | | $0.36 | $12.02 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.47 / $0.47 / $0.47
| Professional | | $0.47 | $0.47 | $0.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.37 / $0.81 / $0.95
| Professional | | $0.37 | $0.81 | $0.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.62 / $0.83 / $0.83
| Facility | | $0.62 | $0.83 | $0.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.35 / $0.39 / $10.23
| Professional | | $0.35 | $0.39 | $10.23 |