- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $58.88 / $194.98
| Facility | | $16.98 | $58.88 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.13 / $19.05
| Professional | | $12.02 | $14.13 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $67.61
| Facility | | $16.22 | $16.22 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $12.30
| Professional | | $7.94 | $7.94 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $75.86 / $112.20
| Professional | | $47.86 | $75.86 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $40.74 / $72.44
| Facility | | $16.22 | $40.74 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $11.75 / $28.18
| Professional | | $8.71 | $11.75 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $19.05 / $23.99
| Professional | | $16.22 | $19.05 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $29.51 / $31.62
| Professional | | $13.18 | $29.51 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $14.13 / $15.14
| Facility | | $13.80 | $14.13 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $33.88 / $45.71
| Professional | | $13.80 | $33.88 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $25.70 / $10,000.00
| Facility | | $14.13 | $25.70 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $25.70 / $10,000.00
| Professional | | $14.13 | $25.70 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $16.22 / $27.54
| Facility | | $6.76 | $16.22 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $9.55 / $16.98
| Professional | | $6.76 | $9.55 | $16.98 |