- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $91.20 / $501.19
| Facility | | $23.99 | $91.20 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.91 / $30.90
| Professional | | $8.51 | $8.91 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $52.48
| Facility | | $12.59 | $12.59 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $8.32
| Professional | | $5.01 | $5.01 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $40.74 / $61.66
| Professional | | $25.70 | $40.74 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $24.55 / $56.23
| Facility | | $12.59 | $24.55 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $8.13 / $18.20
| Professional | | $6.17 | $8.13 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $14.79 / $18.62
| Professional | | $12.59 | $14.79 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $16.60 / $19.05
| Professional | | $8.13 | $16.60 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $9.12 / $10.72
| Facility | | $8.51 | $9.12 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $8.51 / $26.30
| Professional | | $6.46 | $8.51 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $17.38 / $10,000.00
| Facility | | $10.00 | $17.38 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $17.38 / $10,000.00
| Professional | | $10.00 | $17.38 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $12.59 / $16.98
| Facility | | $5.25 | $12.59 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.31 / $13.80
| Professional | | $5.13 | $6.31 | $13.80 |