- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $64.57 / $158.49
| Facility | | $23.44 | $64.57 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.79 / $43.65
| Professional | | $12.02 | $14.79 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $22.91 / $100.00
| Facility | | $14.79 | $22.91 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $16.22 / $39.81
| Professional | | $9.77 | $16.22 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $39.81 / $56.23
| Facility | | $31.62 | $39.81 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $20.89
| Professional | | $15.14 | $15.14 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $25.70 / $63.10
| Facility | | $12.59 | $25.70 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $18.62 / $42.66
| Professional | | $9.77 | $18.62 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $117.49 / $7,079.46
| Facility | | $18.62 | $117.49 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $23.44 / $27.54
| Professional | | $23.44 | $23.44 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $44.67
| Professional | | $16.22 | $16.22 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $21.38 / $138.04
| Facility | | $19.05 | $21.38 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $22.91 / $100.00
| Facility | | $14.79 | $22.91 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $16.22 / $39.81
| Professional | | $9.77 | $16.22 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $19.50 / $27.54
| Facility | | $16.22 | $19.50 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $16.60 / $24.55
| Professional | | $14.13 | $16.60 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $16.22 / $23.44
| Facility | | $8.13 | $16.22 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $15.85 / $43.65
| Professional | | $9.77 | $15.85 | $43.65 |