- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $28.18 / $75.86
| Facility | | $8.91 | $28.18 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.00 / $12.88
| Professional | | $8.91 | $10.00 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $53.70
| Facility | | $12.59 | $12.59 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $6.31 / $9.77
| Professional | | $6.31 | $6.31 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $60.26 / $89.13
| Professional | | $37.15 | $60.26 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $33.11 / $57.54
| Facility | | $12.88 | $33.11 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $9.33 / $21.88
| Professional | | $6.92 | $9.33 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $15.14 / $18.62
| Professional | | $12.59 | $15.14 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $21.38 / $24.55
| Professional | | $10.47 | $21.38 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.80 / $13.80
| Facility | | $10.96 | $13.80 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $23.99 / $26.92
| Professional | | $10.96 | $23.99 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $18.20 / $10,000.00
| Facility | | $9.77 | $18.20 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $18.20 / $10,000.00
| Professional | | $9.77 | $18.20 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $12.59 / $21.88
| Facility | | $5.37 | $12.59 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $7.59 / $13.18
| Professional | | $5.37 | $7.59 | $13.18 |