- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $41.69 / $104.71
| Facility | | $16.98 | $41.69 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $15.85 / $19.05
| Professional | | $14.13 | $15.85 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $79.43
| Facility | | $18.62 | $18.62 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $14.45
| Professional | | $9.33 | $9.33 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $67.61 / $102.33
| Professional | | $42.66 | $67.61 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $47.86 / $85.11
| Facility | | $19.05 | $47.86 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $13.80 / $32.36
| Professional | | $10.23 | $13.80 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $22.39 / $27.54
| Professional | | $18.62 | $22.39 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $31.62 / $36.31
| Professional | | $15.49 | $31.62 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $17.78
| Facility | | $16.22 | $16.22 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $39.81 / $41.69
| Professional | | $16.60 | $39.81 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $26.92 / $10,000.00
| Facility | | $14.45 | $26.92 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $26.92 / $10,000.00
| Professional | | $14.45 | $26.92 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $18.62 / $32.36
| Facility | | $7.94 | $18.62 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.72 / $18.62
| Professional | | $7.94 | $10.72 | $18.62 |