- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $50.12 / $97.72
| Facility | | $16.98 | $50.12 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $16.98 / $21.88
| Professional | | $15.14 | $16.98 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $23.44 / $100.00
| Facility | | $23.44 | $23.44 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $15.85
| Professional | | $9.33 | $9.33 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $77.62 / $114.82
| Professional | | $48.98 | $77.62 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $45.71 / $107.15
| Facility | | $23.99 | $45.71 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.49 / $28.84
| Professional | | $10.96 | $13.49 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $28.18 / $34.67
| Professional | | $23.44 | $28.18 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $27.54 / $32.36
| Professional | | $13.80 | $27.54 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $17.38 / $19.95
| Facility | | $14.13 | $17.38 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $36.31 / $50.12
| Professional | | $14.13 | $36.31 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $31.62 / $10,000.00
| Facility | | $19.05 | $31.62 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $31.62 / $10,000.00
| Professional | | $19.05 | $31.62 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $23.44 / $28.18
| Facility | | $10.00 | $23.44 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $11.75 / $22.91
| Professional | | $9.55 | $11.75 | $22.91 |