- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $75.86 / $251.19
| Facility | | $25.12 | $75.86 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $20.42
| Professional | | $7.94 | $10.00 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $30.90 / $31.62
| Facility | | $24.55 | $30.90 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $41.69
| Professional | | $5.62 | $5.62 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $12.02
| Facility | | $6.92 | $6.92 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $11.48
| Professional | | $11.48 | $11.48 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $37.15 / $58.88
| Facility | | $31.62 | $37.15 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $16.60 / $35.48
| Professional | | $13.18 | $16.60 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $25.12 / $83.18
| Facility | | $10.23 | $25.12 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $14.45 / $102.33
| Facility | | $9.33 | $14.45 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $8.71 / $25.70
| Professional | | $6.61 | $8.71 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $32.36 / $64.57
| Professional | | $11.48 | $32.36 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $29.51
| Facility | | $13.80 | $13.80 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $18.62 / $32.36
| Professional | | $8.51 | $18.62 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $28.84 / $48.98
| Professional | | $15.14 | $28.84 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $22.91 / $100.00
| Facility | | $22.91 | $22.91 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.59 / $11.22
| Professional | | $6.03 | $7.59 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $23.99 / $25.12
| Professional | | $23.99 | $23.99 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $25.12 / $61.66
| Professional | | $25.12 | $25.12 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $10.00 / $27.54
| Facility | | $5.75 | $10.00 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $8.71 / $25.12
| Professional | | $5.75 | $8.71 | $25.12 |