- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $60.26 / $100.00
| Facility | | $12.02 | $60.26 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $14.45 / $26.92
| Professional | | $10.00 | $14.45 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $7.94 / $15.85
| Professional | | $5.62 | $7.94 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $51.29 / $89.13
| Facility | | $17.38 | $51.29 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $10.72 / $12.30
| Professional | | $5.01 | $10.72 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $22.91 / $91.20
| Facility | | $14.45 | $22.91 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $15.85 / $26.92
| Professional | | $11.22 | $15.85 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $15.85 / $15.85
| Facility | | $15.85 | $15.85 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $33.11 / $74.13
| Facility | | $17.78 | $33.11 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $16.22 / $35.48
| Professional | | $10.00 | $16.22 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Facility | | $75.86 | $75.86 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $22.91 / $26.30
| Professional | | $14.13 | $22.91 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $16.98 / $85.11
| Facility | | $12.02 | $16.98 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $14.45 / $28.84
| Professional | | $8.91 | $14.45 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $13.49 / $13.49
| Professional | | $12.02 | $13.49 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $45.71 / $45.71
| Facility | | $41.69 | $45.71 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.85 / $46.77
| Facility | | $12.88 | $15.85 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $15.85 / $26.30
| Professional | | $9.77 | $15.85 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $15.85 / $19.05
| Facility | | $7.08 | $15.85 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $12.88 / $22.39
| Professional | | $9.55 | $12.88 | $22.39 |