- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $199.53 / $1,318.26
| Facility | | $1.29 | $199.53 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $316.23 / $9,120.11
| Professional | | $2.40 | $316.23 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.86 / $100.00
| Facility | | $1.41 | $1.86 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.65 / $7.94
| Professional | | $0.56 | $0.65 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.56 / $1.12
| Facility | | $0.56 | $0.56 | $1.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.93 / $1.02
| Professional | | $0.56 | $0.93 | $1.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $1.12 / $2.29
| Facility | | $0.68 | $1.12 | $2.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.52 / $0.52 / $0.52
| Professional | | $0.52 | $0.52 | $0.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.78 / $5,888.44
| Facility | | $0.56 | $0.78 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.56 / $0.69
| Professional | | $0.56 | $0.56 | $0.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $109.65 / $1,202.26
| Facility | | $2.40 | $109.65 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $33.88
| Professional | | $33.88 | $33.88 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.86 / $100.00
| Facility | | $1.41 | $1.86 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.65 / $7.94
| Professional | | $0.56 | $0.65 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.65 / $1.00 / $1.32
| Facility | | $0.65 | $1.00 | $1.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $0.65 / $2.14
| Professional | | $0.56 | $0.65 | $2.14 |