- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $162.18 / $758.58
| Facility | | $29.51 | $162.18 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $34.67
| Professional | | $6.03 | $7.08 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.25 / $5.89
| Professional | | $4.27 | $5.25 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $8.51 / $10.00
| Facility | | $7.41 | $8.51 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.51 / $12.30
| Professional | | $7.08 | $8.51 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $9.33 / $21.88
| Facility | | $5.89 | $9.33 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $8.71 / $13.49
| Professional | | $5.25 | $8.71 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $35.48 / $77.62
| Facility | | $8.51 | $35.48 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $11.75 / $16.98
| Professional | | $3.89 | $11.75 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $4.07 / $5.25
| Professional | | $1.00 | $4.07 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $6.92 / $10.47
| Facility | | $3.55 | $6.92 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $5.01 / $11.75
| Professional | | $3.16 | $5.01 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $5.25
| Professional | | $5.25 | $5.25 | $5.25 |