- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $23.99 / $69.18
| Facility | | $9.55 | $23.99 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.00 / $15.85
| Professional | | $7.08 | $10.00 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $44.67 / $77.62
| Facility | | $16.98 | $44.67 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.08 / $12.59
| Professional | | $5.01 | $7.08 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $12.88
| Facility | | $12.59 | $12.59 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $28.18 / $67.61
| Facility | | $15.14 | $28.18 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.33 / $21.88
| Professional | | $7.41 | $9.33 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $100.00
| Facility | | $61.66 | $61.66 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $25.70
| Professional | | $25.70 | $25.70 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $12.88 / $57.54
| Facility | | $9.77 | $12.88 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $11.48 / $22.91
| Professional | | $7.08 | $11.48 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $10.72 / $10.72
| Professional | | $9.55 | $10.72 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $13.80 / $38.90
| Facility | | $10.23 | $13.80 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.33 / $21.38
| Professional | | $7.41 | $9.33 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $12.88 / $15.49
| Facility | | $5.75 | $12.88 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $7.59 / $12.88
| Professional | | $5.37 | $7.59 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.61 / $12.88
| Professional | | $5.01 | $6.61 | $12.88 |