- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $39.81 / $112.20
| Facility | | $11.75 | $39.81 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $36.31
| Professional | | $6.03 | $7.08 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $11.48 / $100.00
| Facility | | $7.41 | $11.48 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $8.13 / $19.95
| Professional | | $4.90 | $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
- $7.76 / $7.76 / $10.47
| Professional | | $7.76 | $7.76 | $10.47 |
- 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
- $7.59 / $10.96 / $4,897.79
| Facility | | $7.59 | $10.96 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.72 / $13.80
| Professional | | $8.91 | $10.72 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $24.55
| Professional | | $8.13 | $8.13 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $18.20 / $125.89
| Facility | | $7.41 | $18.20 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $11.48 / $100.00
| Facility | | $7.41 | $11.48 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $8.13 / $19.95
| Professional | | $4.90 | $8.13 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $11.48
| Facility | | $8.32 | $8.32 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $8.13 / $13.49
| Facility | | $4.68 | $8.13 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $8.13 / $22.91
| Professional | | $3.72 | $8.13 | $22.91 |