- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $2,454.71 / $7,585.78
| Facility | | $537.03 | $2,454.71 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.00 / $10.00
| Professional | | $1.00 | $2.00 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.13 / $6.76
| Professional | | $5.01 | $5.13 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $9.33
| Facility | | $9.33 | $9.33 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $5.37 / $35.48
| Facility | | $2.34 | $5.37 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.26 / $9.33
| Professional | | $1.26 | $1.26 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $85.11 / $85.11
| Facility | | $79.43 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $4.68
| Professional | | $4.68 | $4.68 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $575.44 / $4,570.88
| Facility | | $3.80 | $575.44 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $3.02 / $1,047.13
| Professional | | $1.00 | $3.02 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $7.08
| Professional | | $6.76 | $6.76 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $7.24 / $16.22
| Facility | | $2.45 | $7.24 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.26 / $3.02
| Professional | | $1.26 | $1.26 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $3.02 / $4.47
| Facility | | $1.26 | $3.02 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.26 / $3.55
| Professional | | $1.26 | $1.26 | $3.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $4.79 / $9.33
| Professional | | $1.17 | $4.79 | $9.33 |