- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $41.69 / $51.29
| Facility | | $21.88 | $41.69 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $16.98 / $21.88
| Professional | | $12.88 | $16.98 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $50.12 / $51.29
| Facility | | $39.81 | $50.12 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $74.13
| Professional | | $9.12 | $9.12 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $12.59
| Facility | | $12.59 | $12.59 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $60.26 / $95.50
| Facility | | $51.29 | $60.26 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $26.30 / $57.54
| Professional | | $20.89 | $26.30 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $40.74 / $147.91
| Facility | | $16.60 | $40.74 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $17.38 / $100.00
| Facility | | $14.79 | $17.38 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $15.14 / $41.69
| Professional | | $11.22 | $15.14 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $36.31 / $66.07
| Professional | | $9.33 | $36.31 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $22.39 / $52.48
| Facility | | $22.39 | $22.39 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $30.20 / $52.48
| Professional | | $13.80 | $30.20 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $47.86 / $154.88
| Professional | | $24.55 | $47.86 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $37.15 / $100.00
| Facility | | $37.15 | $37.15 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $12.30 / $18.20
| Professional | | $9.77 | $12.30 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $39.81
| Professional | | $19.05 | $19.05 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $102.33
| Professional | | $19.05 | $19.05 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $16.60 / $44.67
| Facility | | $9.33 | $16.60 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $14.79 / $41.69
| Professional | | $9.33 | $14.79 | $41.69 |