- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $67.61 / $181.97
| Facility | | $15.49 | $67.61 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $9.55 / $16.60
| Professional | | $7.94 | $9.55 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $47.86
| Facility | | $11.22 | $11.22 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $8.51
| Professional | | $5.50 | $5.50 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $52.48 / $79.43
| Professional | | $33.11 | $52.48 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $29.51 / $50.12
| Facility | | $11.48 | $29.51 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.32 / $19.50
| Professional | | $6.03 | $8.32 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $13.49 / $16.60
| Professional | | $11.22 | $13.49 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $18.62 / $21.88
| Professional | | $9.33 | $18.62 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $11.48
| Facility | | $9.77 | $9.77 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $11.48 / $23.44
| Professional | | $4.79 | $11.48 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $18.62 / $10,000.00
| Facility | | $10.00 | $18.62 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $19.05 / $10,000.00
| Professional | | $10.00 | $19.05 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $11.22 / $19.05
| Facility | | $4.68 | $11.22 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.76 / $11.75
| Professional | | $4.68 | $6.76 | $11.75 |