- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $40.74 / $95.50
| Facility | | $17.78 | $40.74 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $11.48 / $27.54
| Professional | | $10.00 | $11.48 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $18.20 / $100.00
| Facility | | $11.75 | $18.20 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $12.88 / $31.62
| Professional | | $7.76 | $12.88 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $31.62 / $45.71
| Facility | | $25.12 | $31.62 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $16.60
| Professional | | $12.02 | $12.02 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $20.42 / $50.12
| Facility | | $10.00 | $20.42 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $14.79 / $22.39
| Professional | | $8.71 | $14.79 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $17.38 / $4,897.79
| Facility | | $12.02 | $17.38 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $16.60 / $21.88
| Professional | | $14.13 | $16.60 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $12.88 / $38.90
| Professional | | $12.88 | $12.88 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $16.60 / $81.28
| Facility | | $15.14 | $16.60 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $18.20 / $100.00
| Facility | | $11.75 | $18.20 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $12.88 / $31.62
| Professional | | $7.76 | $12.88 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $15.49 / $20.89
| Facility | | $11.22 | $15.49 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $13.18 / $19.50
| Professional | | $11.22 | $13.18 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $12.88 / $20.89
| Facility | | $7.41 | $12.88 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $12.88 / $38.90
| Professional | | $5.75 | $12.88 | $38.90 |