- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $83.18 / $165.96
| Facility | | $29.51 | $83.18 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.14 / $104.71
| Professional | | $10.00 | $15.14 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $37.15 / $79.43
| Facility | | $8.51 | $37.15 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $13.18 / $41.69
| Professional | | $7.41 | $13.18 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $91.20 / $234.42
| Facility | | $36.31 | $91.20 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $16.98 / $50.12
| Professional | | $11.75 | $16.98 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $28.18 / $57.54
| Facility | | $12.02 | $28.18 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $18.20 / $38.02
| Professional | | $8.91 | $18.20 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $15.85 / $100.00
| Professional | | $15.85 | $15.85 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $15.85 / $36.31
| Professional | | $12.59 | $15.85 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $89.13 / $100.00
| Facility | | $87.10 | $89.13 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $15.85
| Professional | | $7.94 | $7.94 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $19.05 / $47.86
| Facility | | $12.59 | $19.05 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $14.45 / $38.02
| Professional | | $8.91 | $14.45 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $56.23
| Professional | | $56.23 | $56.23 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.96 / $15.85
| Facility | | $7.08 | $10.96 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $8.91 / $31.62
| Professional | | $6.61 | $8.91 | $31.62 |