- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $114.82 / $251.19
| Facility | | $23.99 | $114.82 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $16.98 / $38.02
| Professional | | $14.13 | $16.98 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $81.28
| Facility | | $19.05 | $19.05 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $14.45
| Professional | | $9.33 | $9.33 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $89.13 / $134.90
| Professional | | $56.23 | $89.13 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $50.12 / $87.10
| Facility | | $19.50 | $50.12 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $14.13 / $32.36
| Professional | | $10.47 | $14.13 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $22.91 / $28.18
| Professional | | $19.05 | $22.91 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $31.62 / $37.15
| Professional | | $15.85 | $31.62 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.60 / $17.78
| Facility | | $16.22 | $16.60 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $23.99 / $39.81
| Professional | | $16.22 | $23.99 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $30.90 / $10,000.00
| Facility | | $16.98 | $30.90 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $32.36 / $10,000.00
| Professional | | $16.98 | $32.36 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $19.05 / $32.36
| Facility | | $9.55 | $19.05 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $11.48 / $20.42
| Professional | | $7.94 | $11.48 | $20.42 |