- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $25.12 / $109.65
| Facility | | $7.08 | $25.12 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $10.00
| Professional | | $7.08 | $7.08 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $42.66
| Facility | | $10.00 | $10.00 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.07 / $6.76
| Professional | | $4.07 | $4.07 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $34.67 / $52.48
| Professional | | $21.88 | $34.67 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $19.50 / $45.71
| Facility | | $10.23 | $19.50 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $12.30
| Professional | | $5.01 | $6.03 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.02 / $14.79
| Professional | | $10.00 | $12.02 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $12.88 / $15.14
| Professional | | $6.31 | $12.88 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $7.41 / $8.51
| Facility | | $6.61 | $7.41 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $21.38 / $21.88
| Professional | | $6.61 | $21.38 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $13.18 / $10,000.00
| Facility | | $7.41 | $13.18 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $13.18 / $10,000.00
| Professional | | $7.41 | $13.18 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $10.00 / $13.18
| Facility | | $4.27 | $10.00 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.68 / $10.00
| Professional | | $4.27 | $4.68 | $10.00 |