- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $57.54 / $151.36
| Facility | | $10.00 | $57.54 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.08 / $45.71
| Professional | | $5.75 | $7.08 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $20.42 / $28.18
| Facility | | $12.59 | $20.42 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $8.71 / $14.45
| Professional | | $5.37 | $8.71 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $16.98 / $19.50
| Professional | | $15.85 | $16.98 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $33.11 / $131.83
| Facility | | $7.76 | $33.11 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $9.33 / $20.89
| Professional | | $6.61 | $9.33 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $15.49
| Facility | | $7.76 | $7.76 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $8.91
| Professional | | $7.76 | $7.76 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $10.72 / $23.44
| Facility | | $7.59 | $10.72 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $9.77 / $79.43
| Professional | | $7.76 | $9.77 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $23.44 / $32.36
| Facility | | $11.75 | $23.44 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $7.94 / $10.00
| Professional | | $5.89 | $7.94 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $9.33 / $12.30
| Facility | | $4.90 | $9.33 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.47 / $12.59
| Professional | | $3.24 | $4.47 | $12.59 |