- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $97.72 / $380.19
| Facility | | $24.55 | $97.72 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $83.18
| Professional | | $7.94 | $10.00 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $48.98
| Facility | | $11.48 | $11.48 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $6.92 / $8.91
| Professional | | $5.89 | $6.92 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $50.12 / $75.86
| Professional | | $31.62 | $50.12 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $26.92 / $52.48
| Facility | | $11.75 | $26.92 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $7.94 / $18.62
| Professional | | $5.89 | $7.94 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $13.80 / $16.98
| Professional | | $11.48 | $13.80 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $17.78 / $20.89
| Professional | | $8.91 | $17.78 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.77 / $11.48
| Facility | | $9.33 | $9.77 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $12.02 / $24.55
| Professional | | $9.12 | $12.02 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $18.20 / $10,000.00
| Facility | | $9.55 | $18.20 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $18.20 / $10,000.00
| Professional | | $9.55 | $18.20 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $11.48 / $18.20
| Facility | | $4.90 | $11.48 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $6.61 / $12.59
| Professional | | $4.90 | $6.61 | $12.59 |