- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $57.54 / $125.89
| Facility | | $19.50 | $57.54 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $10.00 / $85.11
| Professional | | $8.71 | $10.00 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $15.14 / $100.00
| Facility | | $9.77 | $15.14 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $11.48 / $28.18
| Professional | | $6.92 | $11.48 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $26.30 / $38.02
| Facility | | $21.38 | $26.30 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $13.80
| Professional | | $10.96 | $10.96 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $16.98 / $41.69
| Facility | | $8.51 | $16.98 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $13.18 / $29.51
| Professional | | $6.92 | $13.18 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $15.49 / $4,897.79
| Facility | | $11.75 | $15.49 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $15.14 / $19.95
| Professional | | $12.59 | $15.14 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $32.36
| Professional | | $11.48 | $11.48 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $20.89 / $104.71
| Facility | | $12.59 | $20.89 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $15.14 / $100.00
| Facility | | $9.77 | $15.14 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $11.48 / $28.18
| Professional | | $6.92 | $11.48 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $13.18 / $26.92
| Facility | | $10.23 | $13.18 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $11.48 / $17.38
| Facility | | $6.17 | $11.48 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $9.33 / $32.36
| Professional | | $6.92 | $9.33 | $32.36 |