- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $31.62 / $58.88
| Facility | | $12.30 | $31.62 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $24.55
| Professional | | $8.91 | $10.96 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $17.38 / $100.00
| Facility | | $11.22 | $17.38 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $12.30 / $29.51
| Professional | | $6.03 | $12.30 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $30.20 / $43.65
| Facility | | $23.99 | $30.20 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $15.49
| Professional | | $11.48 | $11.48 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $19.50 / $46.77
| Facility | | $9.55 | $19.50 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $14.13 / $31.62
| Professional | | $7.41 | $14.13 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $102.33 / $7,079.46
| Facility | | $14.13 | $102.33 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $20.89
| Professional | | $17.78 | $17.78 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $33.11
| Professional | | $12.30 | $12.30 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $17.38 / $100.00
| Facility | | $11.22 | $17.38 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $12.30 / $29.51
| Professional | | $6.03 | $12.30 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $12.30 / $19.95
| Facility | | $7.08 | $12.30 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $10.23 / $33.11
| Professional | | $4.90 | $10.23 | $33.11 |