- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $24.55 / $69.18
| Facility | | $7.94 | $24.55 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $8.91 / $14.45
| Professional | | $7.94 | $8.91 | $14.45 |
- 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
- $5.75 / $5.75 / $8.91
| Professional | | $5.75 | $5.75 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $54.95 / $83.18
| Professional | | $34.67 | $54.95 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $30.20 / $53.70
| Facility | | $12.02 | $30.20 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $8.51 / $19.95
| Professional | | $6.46 | $8.51 | $19.95 |
- 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 / $19.50 / $22.91
| Professional | | $9.77 | $19.50 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $10.96
| Facility | | $10.23 | $10.23 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $23.99 / $24.55
| Professional | | $10.47 | $23.99 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $16.60 / $10,000.00
| Facility | | $9.12 | $16.60 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $16.60 / $10,000.00
| Professional | | $9.12 | $16.60 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $11.75 / $19.95
| Facility | | $4.90 | $11.75 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $7.08 / $12.30
| Professional | | $4.90 | $7.08 | $12.30 |