- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $147.91 / $331.13
| Facility | | $19.50 | $147.91 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $27.54
| Professional | | $7.08 | $8.91 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $43.65
| Facility | | $10.23 | $10.23 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $7.76
| Professional | | $5.01 | $5.01 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $38.02 / $57.54
| Professional | | $23.99 | $38.02 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $25.12 / $45.71
| Facility | | $10.47 | $25.12 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $7.59 / $17.78
| Professional | | $5.50 | $7.59 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.30 / $15.14
| Professional | | $10.23 | $12.30 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $16.98 / $19.95
| Professional | | $8.51 | $16.98 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $9.55
| Facility | | $8.91 | $8.91 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $21.38 / $25.70
| Professional | | $9.12 | $21.38 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $14.79 / $10,000.00
| Facility | | $7.94 | $14.79 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $14.45 / $10,000.00
| Professional | | $7.94 | $14.45 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $10.23 / $17.38
| Facility | | $4.27 | $10.23 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.75 / $11.22
| Professional | | $4.27 | $5.75 | $11.22 |