- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $26.30 / $53.70
| Facility | | $10.23 | $26.30 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $12.02 / $24.55
| Professional | | $5.01 | $12.02 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $19.95 / $100.00
| Facility | | $13.49 | $19.95 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $14.13 / $38.90
| Professional | | $4.57 | $14.13 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $36.31 / $52.48
| Facility | | $29.51 | $36.31 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $14.79 / $15.49
| Professional | | $6.92 | $14.79 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $23.44 / $57.54
| Facility | | $10.47 | $23.44 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $18.20 / $41.69
| Professional | | $9.55 | $18.20 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $53.70 / $7,079.46
| Facility | | $6.31 | $53.70 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $22.91 / $26.92
| Professional | | $22.91 | $22.91 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $15.85 / $33.88
| Professional | | $15.85 | $15.85 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $19.95 / $100.00
| Facility | | $13.49 | $19.95 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $14.13 / $38.90
| Professional | | $4.57 | $14.13 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $15.85 / $21.88
| Facility | | $4.79 | $15.85 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $10.00 / $30.20
| Professional | | $4.57 | $10.00 | $30.20 |