- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $51.29 / $83.18
| Facility | | $17.78 | $51.29 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $15.14 / $33.88
| Professional | | $12.02 | $15.14 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $131.83 / $5,011.87
| Facility | | $100.00 | $131.83 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $14.79 / $18.62
| Professional | | $14.79 | $14.79 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $28.84 / $64.57
| Facility | | $13.49 | $28.84 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $24.55 / $45.71
| Professional | | $10.96 | $24.55 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $11.22 / $27.54
| Professional | | $8.91 | $11.22 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $19.05
| Facility | | $19.05 | $19.05 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $20.89 / $33.11
| Professional | | $18.62 | $20.89 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $50.12 / $64.57
| Facility | | $15.49 | $50.12 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.14 / $21.88
| Professional | | $12.88 | $15.14 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $20.89 / $32.36
| Facility | | $8.71 | $20.89 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $20.89 / $50.12
| Professional | | $8.71 | $20.89 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $19.05 / $22.91
| Facility | | $11.22 | $19.05 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $13.80 / $36.31
| Professional | | $8.51 | $13.80 | $36.31 |