- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $61.66 / $125.89
| Facility | | $28.18 | $61.66 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $15.49 / $30.90
| Professional | | $13.80 | $15.49 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $23.99 / $100.00
| Facility | | $15.49 | $23.99 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $20.89 / $51.29
| Professional | | $8.91 | $20.89 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $42.66 / $60.26
| Facility | | $33.88 | $42.66 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $27.54 / $60.26
| Facility | | $14.79 | $27.54 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $24.55 / $54.95
| Professional | | $12.02 | $24.55 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $123.03 / $7,079.46
| Facility | | $17.78 | $123.03 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $35.48
| Professional | | $30.20 | $30.20 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $20.89 / $47.86
| Professional | | $20.89 | $20.89 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $36.31 / $89.13
| Facility | | $20.42 | $36.31 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $23.99 / $100.00
| Facility | | $15.49 | $23.99 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $20.89 / $51.29
| Professional | | $8.91 | $20.89 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $24.55 / $38.90
| Facility | | $16.60 | $24.55 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $18.62 / $31.62
| Professional | | $15.85 | $18.62 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $19.50 / $25.12
| Facility | | $9.55 | $19.50 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $16.22 / $51.29
| Professional | | $7.76 | $16.22 | $51.29 |