- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $45.71 / $75.86
| Facility | | $17.78 | $45.71 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.85 / $34.67
| Professional | | $12.88 | $15.85 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $24.55 / $100.00
| Facility | | $15.85 | $24.55 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $17.78 / $43.65
| Professional | | $10.72 | $17.78 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $42.66 / $61.66
| Facility | | $34.67 | $42.66 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $22.39
| Professional | | $16.98 | $16.98 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $27.54 / $67.61
| Facility | | $14.13 | $27.54 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $20.42 / $46.77
| Professional | | $10.96 | $20.42 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $102.33 / $7,079.46
| Facility | | $18.62 | $102.33 | $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
- $15.85 / $24.55 / $100.00
| Facility | | $15.85 | $24.55 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $17.78 / $43.65
| Professional | | $10.72 | $17.78 | $43.65 |
- 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 / $47.86
| Professional | | $10.72 | $17.78 | $47.86 |