- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $309.03 / $912.01
| Facility | | $35.48 | $309.03 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $8.51 / $19.95
| Professional | | $6.92 | $8.51 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.31 / $10.47
| Professional | | $5.13 | $6.31 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $32.36 / $61.66
| Facility | | $11.48 | $32.36 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.75 / $8.51
| Professional | | $5.01 | $5.75 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $15.14 / $75.86
| Facility | | $7.41 | $15.14 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $14.45 / $19.95
| Professional | | $7.41 | $14.45 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $10.47 / $10.47
| Facility | | $10.47 | $10.47 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $22.91 / $52.48
| Facility | | $12.02 | $22.91 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $10.96 / $19.50
| Professional | | $6.03 | $10.96 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $91.20 / $100.00
| Facility | | $91.20 | $91.20 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $13.49 / $19.50
| Professional | | $9.12 | $13.49 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $194.98 / $851.14
| Facility | | $10.47 | $194.98 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $8.91 / $20.89
| Professional | | $6.31 | $8.91 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $8.91 / $8.91
| Professional | | $7.94 | $8.91 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.47 / $30.90
| Facility | | $8.32 | $10.47 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $10.23 / $18.62
| Professional | | $6.03 | $10.23 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $10.47 / $12.59
| Facility | | $4.47 | $10.47 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.17 / $14.79
| Professional | | $4.47 | $6.17 | $14.79 |