- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $158.49 / $616.60
| Facility | | $54.95 | $158.49 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $63.10 / $3,090.30
| Professional | | $13.49 | $63.10 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.10 / $0.10 / $0.10
| Facility | | $0.10 | $0.10 | $0.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.08 / $0.08 / $0.10
| Professional | | $0.08 | $0.08 | $0.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.08 / $0.08 / $0.12
| Facility | | $0.08 | $0.08 | $0.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.08 / $0.09 / $0.16
| Professional | | $0.08 | $0.09 | $0.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.10 / $0.13 / $0.20
| Facility | | $0.10 | $0.13 | $0.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.04 / $0.08 / $0.10
| Professional | | $0.04 | $0.08 | $0.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.08 / $0.08 / $1.05
| Facility | | $0.08 | $0.08 | $1.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.08 / $0.16 / $19.95
| Professional | | $0.08 | $0.16 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.09 / $1.32
| Facility | | $0.09 | $0.09 | $1.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.09 / $0.14 / $776.25
| Professional | | $0.09 | $0.14 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $64.57 / $85.11
| Professional | | $50.12 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.07 / $0.07 / $8.13
| Facility | | $0.07 | $0.07 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.06 / $0.08 / $0.14
| Professional | | $0.06 | $0.08 | $0.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.20 / $0.65 / $1.10
| Professional | | $0.20 | $0.65 | $1.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $85.11 / $100.00
| Facility | | $0.05 | $85.11 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.37 / $776.25
| Professional | | $0.05 | $0.37 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.11 / $0.18 / $0.28
| Professional | | $0.11 | $0.18 | $0.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.05 / $0.12
| Facility | | $0.05 | $0.05 | $0.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $67.61 / $100.00
| Professional | | $0.05 | $67.61 | $100.00 |