- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $40.74 / $144.54
| Facility | | $15.85 | $40.74 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.49 / $21.38
| Professional | | $12.88 | $15.49 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $75.86
| Facility | | $17.78 | $17.78 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.51 / $13.49
| Professional | | $8.51 | $8.51 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $81.28 / $120.23
| Professional | | $51.29 | $81.28 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $43.65 / $79.43
| Facility | | $17.78 | $43.65 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $12.59 / $30.20
| Professional | | $9.33 | $12.59 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $21.38 / $26.30
| Professional | | $17.78 | $21.38 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $28.84 / $33.88
| Professional | | $14.13 | $28.84 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $15.85 / $16.22
| Facility | | $14.79 | $15.85 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $21.38 / $37.15
| Professional | | $14.79 | $21.38 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $25.12 / $10,000.00
| Facility | | $13.49 | $25.12 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $25.12 / $10,000.00
| Professional | | $13.49 | $25.12 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $17.78 / $29.51
| Facility | | $7.41 | $17.78 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.47 / $18.20
| Professional | | $7.41 | $10.47 | $18.20 |