- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $57.54 / $181.97
| Facility | | $13.80 | $57.54 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.61 / $23.99
| Professional | | $6.03 | $6.61 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $11.48 / $66.07
| Facility | | $7.41 | $11.48 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.13 / $19.95
| Professional | | $4.07 | $8.13 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $19.95 / $28.84
| Facility | | $16.22 | $19.95 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.23 / $10.23
| Professional | | $7.94 | $10.23 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $12.88 / $31.62
| Facility | | $6.31 | $12.88 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $9.55 / $21.88
| Professional | | $5.01 | $9.55 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $81.28 / $7,079.46
| Facility | | $9.33 | $81.28 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $13.80
| Professional | | $11.75 | $11.75 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $22.39
| Professional | | $8.13 | $8.13 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.02 / $91.20
| Facility | | $10.00 | $12.02 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $11.48 / $66.07
| Facility | | $7.41 | $11.48 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.13 / $19.95
| Professional | | $4.07 | $8.13 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $9.55 / $19.05
| Facility | | $7.24 | $9.55 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $8.32 / $12.30
| Professional | | $7.24 | $8.32 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.13 / $12.02
| Facility | | $4.07 | $8.13 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $6.92 / $22.39
| Professional | | $3.24 | $6.92 | $22.39 |