- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $7.76 / $100.00
| Facility | | $1.95 | $7.76 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $3.89 / $89.13
| Professional | | $1.00 | $3.89 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $5.01 / $100.00
| Facility | | $1.82 | $5.01 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.04 / $60.26
| Professional | | $1.95 | $2.04 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.04 / $4.07
| Facility | | $2.04 | $2.04 | $4.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $3.72 / $4.17
| Professional | | $2.29 | $3.72 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $4.37 / $8.91
| Facility | | $2.63 | $4.37 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.04 / $2.04
| Professional | | $2.04 | $2.04 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.88 / $5,888.44
| Facility | | $2.04 | $2.88 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.04 / $2.40
| Professional | | $2.04 | $2.04 | $2.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $17.78 / $79.43
| Facility | | $3.31 | $17.78 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $5.01 / $100.00
| Facility | | $1.82 | $5.01 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.04 / $60.26
| Professional | | $1.95 | $2.04 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $1.78 / $2.40
| Facility | | $1.45 | $1.78 | $2.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $3.63 / $4.79
| Facility | | $2.34 | $3.63 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.34 / $3.47
| Professional | | $1.95 | $2.34 | $3.47 |