- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $28.84 / $79.43
| Facility | | $10.96 | $28.84 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.59 / $18.20
| Professional | | $8.91 | $12.59 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.76 / $9.33
| Professional | | $7.41 | $7.76 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $52.48 / $87.10
| Facility | | $19.95 | $52.48 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $8.51 / $15.14
| Professional | | $5.01 | $8.51 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $15.49 / $23.44
| Professional | | $10.72 | $15.49 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $16.60
| Facility | | $15.49 | $15.49 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $33.11 / $83.18
| Facility | | $16.60 | $33.11 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $10.47 / $23.99
| Professional | | $8.13 | $10.47 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $74.13 / $100.00
| Facility | | $74.13 | $74.13 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $28.84 / $28.84
| Professional | | $28.84 | $28.84 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $15.49 / $52.48
| Facility | | $11.75 | $15.49 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $13.80 / $25.70
| Professional | | $8.91 | $13.80 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $12.88 / $12.88
| Professional | | $11.48 | $12.88 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $15.49 / $45.71
| Facility | | $11.75 | $15.49 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $10.47 / $23.99
| Professional | | $8.13 | $10.47 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $15.49 / $18.62
| Facility | | $6.61 | $15.49 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $8.32 / $14.79
| Professional | | $6.46 | $8.32 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.94 / $15.49
| Professional | | $6.03 | $7.94 | $15.49 |