- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $123.03 / $123.03
| Facility | | $1.35 | $123.03 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $11.22 / $95.50
| Professional | | $1.32 | $11.22 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.93 / $1.12 / $100.00
| Facility | | $0.93 | $1.12 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.46 / $602.56
| Professional | | $0.41 | $0.46 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.41 / $0.81
| Facility | | $0.41 | $0.41 | $0.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.68 / $0.89
| Professional | | $0.41 | $0.68 | $0.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.87 / $1.78
| Facility | | $0.52 | $0.87 | $1.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.41 / $0.41
| Professional | | $0.41 | $0.41 | $0.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.56 / $5,888.44
| Facility | | $0.41 | $0.56 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.41 / $0.49
| Professional | | $0.41 | $0.41 | $0.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $181.97 / $181.97
| Facility | | $181.97 | $181.97 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.93 / $1.12 / $100.00
| Facility | | $0.93 | $1.12 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.41 / $0.46 / $602.56
| Professional | | $0.41 | $0.46 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $5.25 / $6.03
| Facility | | $1.07 | $5.25 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.34 / $0.52 / $0.69
| Facility | | $0.34 | $0.52 | $0.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.34 / $0.46 / $1.07
| Professional | | $0.34 | $0.46 | $1.07 |