- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $234.42 / $4,073.80
| Facility | | $2.95 | $234.42 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.00 / $16.98
| Professional | | $2.00 | $2.00 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $21.88 / $22.91
| Facility | | $19.05 | $21.88 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.98 / $8.32 / $14.13
| Professional | | $0.98 | $8.32 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48,977.88 / $48,977.88 / $48,977.88
| Facility | | $48,977.88 | $48,977.88 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $7.59 / $13.18
| Facility | | $3.63 | $7.59 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $2.75 / $2.75
| Professional | | $2.75 | $2.75 | $2.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $2.57 / $3.24
| Facility | | $2.57 | $2.57 | $3.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $5.50 / $100.00
| Facility | | $3.80 | $5.50 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $2,187.76
| Professional | | $2.69 | $2.69 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $54.95 / $70.79
| Professional | | $32.36 | $54.95 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.51 / $8.51
| Facility | | $8.13 | $8.51 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $85.11 / $100.00
| Facility | | $2.75 | $85.11 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $19.05 / $2,187.76
| Professional | | $2.75 | $19.05 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $17.78
| Facility | | $7.59 | $7.59 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $4.37
| Professional | | $2.69 | $2.69 | $4.37 |