- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $45.71 / $120.23
| Facility | | $17.78 | $45.71 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $16.98 / $23.99
| Professional | | $15.14 | $16.98 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $87.10
| Facility | | $20.42 | $20.42 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $15.49
| Professional | | $10.00 | $10.00 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $33.11 / $48.98
| Professional | | $20.89 | $33.11 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $47.86 / $91.20
| Facility | | $20.89 | $47.86 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $14.79 / $35.48
| Professional | | $10.96 | $14.79 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $24.55 / $30.20
| Professional | | $20.42 | $24.55 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $33.88 / $39.81
| Professional | | $16.98 | $33.88 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $18.20 / $19.05
| Facility | | $17.38 | $18.20 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $21.88 / $42.66
| Professional | | $17.38 | $21.88 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $29.51 / $10,000.00
| Facility | | $15.85 | $29.51 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $28.84 / $10,000.00
| Professional | | $15.85 | $28.84 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $20.42 / $34.67
| Facility | | $8.51 | $20.42 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $9.12 / $16.60
| Professional | | $4.07 | $9.12 | $16.60 |