- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $43.65 / $95.50
| Facility | | $14.13 | $43.65 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $15.14 / $18.20
| Professional | | $14.13 | $15.14 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $83.18
| Facility | | $19.95 | $19.95 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $13.18
| Professional | | $7.94 | $7.94 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $74.13 / $112.20
| Professional | | $46.77 | $74.13 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $41.69 / $91.20
| Facility | | $20.42 | $41.69 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $12.02 / $27.54
| Professional | | $9.77 | $12.02 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $23.99 / $29.51
| Professional | | $19.95 | $23.99 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $26.92 / $30.90
| Professional | | $13.18 | $26.92 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $14.45 / $16.98
| Facility | | $13.80 | $14.45 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $32.36 / $41.69
| Professional | | $13.80 | $32.36 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $26.30 / $10,000.00
| Facility | | $14.45 | $26.30 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $26.30 / $10,000.00
| Professional | | $14.45 | $26.30 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $19.95 / $27.54
| Facility | | $8.32 | $19.95 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.00 / $21.88
| Professional | | $8.32 | $10.00 | $21.88 |