- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $33.88 / $117.49
| Facility | | $15.49 | $33.88 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $15.14
| Professional | | $8.91 | $10.96 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $56.23
| Facility | | $13.18 | $13.18 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $6.61 / $10.23
| Professional | | $6.61 | $6.61 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $63.10 / $93.33
| Professional | | $38.90 | $63.10 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $35.48 / $60.26
| Facility | | $13.49 | $35.48 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $9.77 / $22.91
| Professional | | $7.24 | $9.77 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $15.85 / $19.50
| Professional | | $13.18 | $15.85 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $22.39 / $25.70
| Professional | | $10.96 | $22.39 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $12.02 / $12.59
| Facility | | $11.75 | $12.02 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $13.18 / $28.18
| Professional | | $11.75 | $13.18 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $22.39 / $10,000.00
| Facility | | $11.75 | $22.39 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $22.91 / $10,000.00
| Professional | | $11.75 | $22.91 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $13.18 / $22.91
| Facility | | $5.62 | $13.18 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $7.94 / $13.80
| Professional | | $5.62 | $7.94 | $13.80 |