- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $39.81 / $85.11
| Facility | | $12.88 | $39.81 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.88 / $18.20
| Professional | | $12.02 | $12.88 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $72.44
| Facility | | $17.38 | $17.38 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.51 / $13.18
| Professional | | $8.51 | $8.51 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $69.18 / $102.33
| Professional | | $42.66 | $69.18 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $40.74 / $77.62
| Facility | | $17.38 | $40.74 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $12.59 / $29.51
| Professional | | $9.33 | $12.59 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $20.42 / $25.70
| Professional | | $17.38 | $20.42 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $28.84 / $33.88
| Professional | | $14.13 | $28.84 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.49 / $16.22
| Facility | | $15.14 | $15.49 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $36.31 / $47.86
| Professional | | $15.14 | $36.31 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $25.12 / $10,000.00
| Facility | | $13.49 | $25.12 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $24.55 / $10,000.00
| Professional | | $13.49 | $24.55 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $17.38 / $29.51
| Facility | | $7.24 | $17.38 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $8.91 / $17.38
| Professional | | $7.24 | $8.91 | $17.38 |