- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $41.69 / $131.83
| Facility | | $14.13 | $41.69 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.13 / $18.62
| Professional | | $12.02 | $14.13 | $18.62 |
- 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
- $7.59 / $7.59 / $12.59
| Professional | | $7.59 | $7.59 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $63.10 / $93.33
| Professional | | $39.81 | $63.10 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $36.31 / $85.11
| Facility | | $19.05 | $36.31 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $22.91
| Professional | | $8.91 | $10.96 | $22.91 |
- 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
- $10.96 / $22.39 / $26.30
| Professional | | $10.96 | $22.39 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $13.80 / $15.85
| Facility | | $11.48 | $13.80 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $23.99 / $39.81
| Professional | | $11.48 | $23.99 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $23.44 / $10,000.00
| Facility | | $13.80 | $23.44 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $23.44 / $10,000.00
| Professional | | $13.80 | $23.44 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $18.62 / $22.91
| Facility | | $7.94 | $18.62 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $9.33 / $18.62
| Professional | | $7.76 | $9.33 | $18.62 |