- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $38.90 / $91.20
| Facility | | $12.88 | $38.90 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $14.13 / $28.18
| Professional | | $12.88 | $14.13 | $28.18 |
- 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
- $7.41 / $7.41 / $12.59
| Professional | | $7.41 | $7.41 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $70.79 / $107.15
| Professional | | $44.67 | $70.79 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $35.48 / $79.43
| Facility | | $18.20 | $35.48 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $11.22 / $25.70
| Professional | | $8.71 | $11.22 | $25.70 |
- 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
- $9.55 / $25.12 / $29.51
| Professional | | $9.55 | $25.12 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $19.05 / $19.05
| Facility | | $12.88 | $19.05 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $23.99 / $37.15
| Professional | | $12.88 | $23.99 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $23.44 / $10,000.00
| Facility | | $12.88 | $23.44 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $23.44 / $10,000.00
| Professional | | $12.88 | $23.44 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $17.78 / $25.70
| Facility | | $7.41 | $17.78 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.33 / $17.78
| Professional | | $7.41 | $9.33 | $17.78 |