- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $24.55 / $41.69
| Facility | | $5.01 | $24.55 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $10.96 / $20.42
| Professional | | $5.01 | $10.96 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $16.22 / $100.00
| Facility | | $10.47 | $16.22 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $12.30 / $33.88
| Professional | | $5.25 | $12.30 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $28.18 / $39.81
| Facility | | $22.39 | $28.18 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $13.18 / $13.80
| Professional | | $7.59 | $13.18 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $12.02 / $22.91
| Facility | | $6.61 | $12.02 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $15.14 / $37.15
| Professional | | $4.57 | $15.14 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $28.18 / $7,079.46
| Facility | | $5.13 | $28.18 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $23.44
| Professional | | $19.95 | $19.95 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $29.51
| Professional | | $14.13 | $14.13 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $16.22 / $100.00
| Facility | | $10.47 | $16.22 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $12.30 / $33.88
| Professional | | $5.25 | $12.30 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $9.77 / $14.13
| Facility | | $5.01 | $9.77 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $10.47 / $28.18
| Professional | | $5.01 | $10.47 | $28.18 |