- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $79.43 / $234.42
| Facility | | $16.98 | $79.43 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.88 / $16.98
| Professional | | $8.91 | $12.88 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $8.91 / $10.00
| Professional | | $6.92 | $8.91 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $44.67 / $85.11
| Facility | | $15.85 | $44.67 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.94 / $14.45
| Professional | | $5.01 | $7.94 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $21.88 / $208.93
| Facility | | $14.13 | $21.88 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $14.45 / $23.44
| Professional | | $10.23 | $14.45 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $20.42 / $20.42
| Facility | | $14.45 | $20.42 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $32.36 / $77.62
| Facility | | $16.98 | $32.36 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.72 / $24.55
| Professional | | $8.32 | $10.72 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $69.18 / $100.00
| Facility | | $69.18 | $69.18 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $21.38 / $23.99
| Professional | | $13.18 | $21.38 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $23.44 / $204.17
| Facility | | $10.96 | $23.44 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $13.18 / $23.44
| Professional | | $7.94 | $13.18 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.30 / $12.30
| Professional | | $10.96 | $12.30 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $2,454.71 / $2,454.71
| Facility | | $1,698.24 | $2,454.71 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $14.45 / $42.66
| Facility | | $11.75 | $14.45 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.72 / $23.99
| Professional | | $8.32 | $10.72 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $14.45 / $17.38
| Facility | | $6.61 | $14.45 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $8.51 / $14.45
| Professional | | $6.17 | $8.51 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $7.59 / $14.45
| Professional | | $5.62 | $7.59 | $14.45 |