- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $31.62 / $38.90
| Facility | | $15.85 | $31.62 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $15.85
| Professional | | $8.91 | $10.96 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $38.02 / $38.90
| Facility | | $30.20 | $38.02 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $48.98
| Professional | | $5.62 | $5.62 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $8.32
| Facility | | $8.32 | $8.32 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $45.71 / $72.44
| Facility | | $38.90 | $45.71 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $19.95 / $43.65
| Professional | | $16.22 | $19.95 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $28.18 / $47.86
| Facility | | $5.37 | $28.18 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $12.59 / $100.00
| Facility | | $5.37 | $12.59 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $8.51 / $21.88
| Professional | | $4.90 | $8.51 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $21.38 / $64.57
| Professional | | $8.13 | $21.38 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $16.98 / $21.88
| Facility | | $15.14 | $16.98 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $14.45 / $39.81
| Professional | | $10.47 | $14.45 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $34.67 / $47.86
| Professional | | $18.62 | $34.67 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $100.00 / $100.00
| Facility | | $28.18 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $3.98 / $5.75
| Professional | | $3.89 | $3.98 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $30.20
| Professional | | $6.17 | $6.17 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $77.62
| Professional | | $6.17 | $6.17 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $11.22 / $16.98
| Facility | | $5.13 | $11.22 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $8.51 / $21.38
| Professional | | $5.01 | $8.51 | $21.38 |