- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $19.95 / $100.00
| Facility | | $3.31 | $19.95 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $14.13 / $20.42
| Professional | | $2.00 | $14.13 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $10.47 / $10.72
| Professional | | $10.47 | $10.47 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $17.78 / $20.89
| Facility | | $15.49 | $17.78 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $17.78 / $17.78
| Professional | | $4.47 | $17.78 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $19.05 / $45.71
| Facility | | $11.75 | $19.05 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $17.38 / $34.67
| Professional | | $9.12 | $17.38 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $12.88 / $28.18
| Facility | | $3.09 | $12.88 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $10.47 / $14.13
| Professional | | $5.13 | $10.47 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $3.24 / $4.07
| Professional | | $2.95 | $3.24 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $14.13 / $21.38
| Facility | | $7.41 | $14.13 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $7.41 / $23.99
| Professional | | $1.78 | $7.41 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $9.12 / $17.78
| Professional | | $3.63 | $9.12 | $17.78 |