- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $36.31 / $58.88
| Facility | | $12.88 | $36.31 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.59 / $23.99
| Professional | | $10.00 | $12.59 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $19.50 / $70.79
| Facility | | $12.59 | $19.50 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $14.13 / $34.67
| Professional | | $6.92 | $14.13 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $34.67 / $48.98
| Facility | | $27.54 | $34.67 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $17.78
| Professional | | $13.18 | $13.18 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $21.88 / $53.70
| Facility | | $10.96 | $21.88 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $16.60 / $37.15
| Professional | | $8.51 | $16.60 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $109.65 / $7,079.46
| Facility | | $15.85 | $109.65 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $23.99
| Professional | | $20.42 | $20.42 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $38.02
| Professional | | $14.13 | $14.13 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $19.50 / $70.79
| Facility | | $12.59 | $19.50 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $14.13 / $34.67
| Professional | | $6.92 | $14.13 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $14.13 / $20.42
| Facility | | $7.08 | $14.13 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $11.75 / $38.02
| Professional | | $6.31 | $11.75 | $38.02 |