- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $21.88 / $63.10
| Facility | | $9.12 | $21.88 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $10.00 / $14.79
| Professional | | $6.03 | $10.00 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.41 / $7.41
| Professional | | $5.01 | $7.41 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $13.49 / $13.49
| Facility | | $6.03 | $13.49 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $21.88 / $58.88
| Facility | | $6.31 | $21.88 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $6.76 / $19.05
| Professional | | $3.31 | $6.76 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $70.79 / $100.00
| Facility | | $70.79 | $70.79 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $21.88 / $21.88
| Professional | | $21.88 | $21.88 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $13.49 / $25.12
| Facility | | $8.71 | $13.49 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $10.23 / $19.05
| Professional | | $6.76 | $10.23 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $11.22 / $11.22
| Professional | | $10.00 | $11.22 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $13.49 / $32.36
| Facility | | $7.41 | $13.49 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $6.76 / $14.45
| Professional | | $3.31 | $6.76 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $13.49 / $15.85
| Facility | | $3.89 | $13.49 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $5.62 / $7.94
| Professional | | $2.95 | $5.62 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $6.92 / $13.49
| Professional | | $5.25 | $6.92 | $13.49 |