- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $44.67 / $213.80
| Facility | | $15.14 | $44.67 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $15.14 / $43.65
| Professional | | $12.02 | $15.14 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $67.61
| Facility | | $16.22 | $16.22 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $12.30
| Professional | | $7.94 | $7.94 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $46.77 / $69.18
| Professional | | $29.51 | $46.77 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $38.90 / $72.44
| Facility | | $16.22 | $38.90 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $11.75 / $25.70
| Professional | | $8.71 | $11.75 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $19.50 / $23.99
| Professional | | $16.22 | $19.50 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $26.92 / $31.62
| Professional | | $9.55 | $26.92 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $16.60
| Facility | | $14.13 | $14.13 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $33.88 / $47.86
| Professional | | $16.60 | $33.88 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $23.44 / $10,000.00
| Facility | | $12.59 | $23.44 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $22.91 / $10,000.00
| Professional | | $12.59 | $22.91 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $16.22 / $27.54
| Facility | | $6.76 | $16.22 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $7.94 / $13.80
| Professional | | $5.89 | $7.94 | $13.80 |