- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $48.98 / $114.82
| Facility | | $18.62 | $48.98 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $16.98 / $37.15
| Professional | | $14.13 | $16.98 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $26.30 / $100.00
| Facility | | $16.98 | $26.30 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $18.62 / $44.67
| Professional | | $11.22 | $18.62 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $45.71 / $66.07
| Facility | | $36.31 | $45.71 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $23.99
| Professional | | $17.38 | $17.38 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $29.51 / $70.79
| Facility | | $14.45 | $29.51 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $20.89 / $48.98
| Professional | | $11.48 | $20.89 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $89.13 / $7,079.46
| Facility | | $16.22 | $89.13 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $26.30 / $31.62
| Professional | | $26.30 | $26.30 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $50.12
| Professional | | $18.62 | $18.62 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $26.30 / $100.00
| Facility | | $16.98 | $26.30 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $18.62 / $44.67
| Professional | | $11.22 | $18.62 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $18.62 / $30.20
| Facility | | $10.72 | $18.62 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $15.49 / $50.12
| Professional | | $11.22 | $15.49 | $50.12 |