- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $38.02 / $100.00
| Facility | | $19.05 | $38.02 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $17.78 / $23.99
| Professional | | $14.13 | $17.78 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $87.10
| Facility | | $20.42 | $20.42 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $15.49
| Professional | | $10.00 | $10.00 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $93.33 / $138.04
| Professional | | $58.88 | $93.33 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $50.12 / $91.20
| Facility | | $20.42 | $50.12 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $14.79 / $29.51
| Professional | | $10.96 | $14.79 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $24.55 / $30.20
| Professional | | $20.42 | $24.55 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $33.88 / $39.81
| Professional | | $16.60 | $33.88 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $18.20 / $19.05
| Facility | | $17.38 | $18.20 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $38.02 / $42.66
| Professional | | $17.38 | $38.02 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $29.51 / $10,000.00
| Facility | | $15.85 | $29.51 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $28.84 / $10,000.00
| Professional | | $15.85 | $28.84 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $20.42 / $34.67
| Facility | | $8.51 | $20.42 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $12.02 / $22.39
| Professional | | $8.51 | $12.02 | $22.39 |