- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $204.17 / $954.99
| Facility | | $33.11 | $204.17 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $8.91 / $29.51
| Professional | | $7.76 | $8.91 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $7.41 / $17.38
| Professional | | $2.88 | $7.41 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $26.30 / $33.88
| Facility | | $22.39 | $26.30 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $7.59
| Professional | | $6.92 | $6.92 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $22.39 / $47.86
| Facility | | $7.24 | $22.39 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $7.41 / $16.22
| Professional | | $5.50 | $7.41 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $14.45 / $18.62
| Professional | | $8.71 | $14.45 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.32 / $16.60
| Facility | | $8.13 | $8.32 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.72 / $11.48
| Professional | | $8.51 | $10.72 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $10.47 / $18.62
| Facility | | $5.25 | $10.47 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.03 / $14.79
| Professional | | $4.47 | $6.03 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $91.20 / $100.00
| Facility | | $91.20 | $91.20 | $100.00 |