- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $48.98 / $204.17
| Facility | | $17.78 | $48.98 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $16.98 / $27.54
| Professional | | $14.13 | $16.98 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $79.43
| Facility | | $18.62 | $18.62 | $79.43 |
- 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
- $51.29 / $81.28 / $123.03
| Professional | | $51.29 | $81.28 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $48.98 / $85.11
| Facility | | $19.05 | $48.98 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $13.80 / $32.36
| Professional | | $10.23 | $13.80 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $22.39 / $27.54
| Professional | | $18.62 | $22.39 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $31.62 / $37.15
| Professional | | $15.49 | $31.62 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.98 / $17.78
| Facility | | $16.22 | $16.98 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $18.62 / $39.81
| Professional | | $16.22 | $18.62 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $31.62 / $10,000.00
| Facility | | $16.60 | $31.62 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $32.36 / $10,000.00
| Professional | | $16.60 | $32.36 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $18.62 / $32.36
| Facility | | $7.94 | $18.62 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.72 / $18.62
| Professional | | $7.94 | $10.72 | $18.62 |