- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $45.71 / $75.86
| Facility | | $15.85 | $45.71 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.85 / $35.48
| Professional | | $12.88 | $15.85 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $25.12 / $100.00
| Facility | | $16.22 | $25.12 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $17.78 / $42.66
| Professional | | $10.72 | $17.78 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $43.65 / $63.10
| Facility | | $34.67 | $43.65 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $22.39
| Professional | | $16.60 | $16.60 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $28.18 / $67.61
| Facility | | $13.80 | $28.18 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $20.42 / $45.71
| Professional | | $10.72 | $20.42 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $144.54 / $7,079.46
| Facility | | $20.42 | $144.54 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $30.20
| Professional | | $25.70 | $25.70 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $47.86
| Professional | | $17.78 | $17.78 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $25.12 / $100.00
| Facility | | $16.22 | $25.12 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $17.78 / $42.66
| Professional | | $10.72 | $17.78 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $17.78 / $25.70
| Facility | | $8.91 | $17.78 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $17.78 / $44.67
| Professional | | $10.72 | $17.78 | $44.67 |