- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $56.23 / $288.40
| Facility | | $14.45 | $56.23 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.47 / $19.95
| Professional | | $7.94 | $10.47 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $50.12
| Facility | | $11.75 | $11.75 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $5.89 / $9.12
| Professional | | $5.89 | $5.89 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $45.71 / $67.61
| Professional | | $28.84 | $45.71 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $28.84 / $53.70
| Facility | | $12.02 | $28.84 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $8.71 / $20.42
| Professional | | $6.46 | $8.71 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $14.13 / $17.38
| Professional | | $11.75 | $14.13 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $19.95 / $22.91
| Professional | | $9.77 | $19.95 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $10.72 / $11.22
| Facility | | $10.47 | $10.72 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $25.12 / $31.62
| Professional | | $10.47 | $25.12 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $19.50 / $10,000.00
| Facility | | $10.47 | $19.50 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $19.50 / $10,000.00
| Professional | | $10.47 | $19.50 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $11.75 / $20.42
| Facility | | $5.01 | $11.75 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.76 / $11.75
| Professional | | $5.01 | $6.76 | $11.75 |