- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $44.67 / $169.82
| Facility | | $15.85 | $44.67 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.45 / $19.05
| Professional | | $12.02 | $14.45 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $69.18
| Facility | | $16.22 | $16.22 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $12.30
| Professional | | $7.94 | $7.94 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $75.86 / $114.82
| Professional | | $47.86 | $75.86 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $42.66 / $72.44
| Facility | | $16.60 | $42.66 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $11.75 / $28.18
| Professional | | $8.91 | $11.75 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $19.50 / $23.99
| Professional | | $16.22 | $19.50 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $26.92 / $31.62
| Professional | | $13.49 | $26.92 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $14.79 / $15.14
| Facility | | $13.80 | $14.79 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $16.98 / $33.88
| Professional | | $13.80 | $16.98 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $23.44 / $10,000.00
| Facility | | $12.59 | $23.44 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $23.44 / $10,000.00
| Professional | | $12.59 | $23.44 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $16.22 / $27.54
| Facility | | $6.76 | $16.22 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $9.77 / $16.98
| Professional | | $6.76 | $9.77 | $16.98 |