- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $85.11 / $288.40
| Facility | | $17.38 | $85.11 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.02 / $15.85
| Professional | | $10.00 | $12.02 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $58.88
| Facility | | $13.80 | $13.80 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $10.47
| Professional | | $6.76 | $6.76 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $64.57 / $97.72
| Professional | | $40.74 | $64.57 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $33.88 / $61.66
| Facility | | $14.13 | $33.88 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.00 / $23.44
| Professional | | $7.41 | $10.00 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $16.60 / $20.42
| Professional | | $13.80 | $16.60 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $22.91 / $26.92
| Professional | | $11.48 | $22.91 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.59 / $12.88
| Facility | | $12.02 | $12.59 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.13 / $28.84
| Professional | | $12.02 | $14.13 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $23.44 / $10,000.00
| Facility | | $12.30 | $23.44 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $23.99 / $10,000.00
| Professional | | $12.30 | $23.99 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $13.80 / $23.44
| Facility | | $5.75 | $13.80 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $8.32 / $15.14
| Professional | | $5.75 | $8.32 | $15.14 |