- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $34.67 / $87.10
| Facility | | $10.96 | $34.67 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.02 / $15.14
| Professional | | $10.96 | $12.02 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $15.85 / $67.61
| Facility | | $15.85 | $15.85 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $12.02
| Professional | | $7.24 | $7.24 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $69.18 / $102.33
| Professional | | $42.66 | $69.18 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $38.02 / $70.79
| Facility | | $16.22 | $38.02 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.72 / $25.12
| Professional | | $7.94 | $10.72 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $19.05 / $23.44
| Professional | | $15.85 | $19.05 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $24.55 / $28.18
| Professional | | $9.55 | $24.55 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $13.18 / $14.13
| Facility | | $12.88 | $13.18 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $16.98 / $33.11
| Professional | | $12.88 | $16.98 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $21.38 / $10,000.00
| Facility | | $11.48 | $21.38 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $21.38 / $10,000.00
| Professional | | $11.48 | $21.38 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $15.85 / $25.12
| Facility | | $6.61 | $15.85 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $8.91 / $17.38
| Professional | | $6.61 | $8.91 | $17.38 |