- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $36.31 / $109.65
| Facility | | $18.20 | $36.31 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $11.75 / $15.14
| Professional | | $10.00 | $11.75 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $35.48 / $36.31
| Facility | | $28.18 | $35.48 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $6.61 / $52.48
| Professional | | $6.61 | $6.61 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $10.72
| Facility | | $10.72 | $10.72 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $41.69 / $67.61
| Facility | | $36.31 | $41.69 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $19.05 / $41.69
| Professional | | $15.14 | $19.05 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $28.84 / $100.00
| Facility | | $11.75 | $28.84 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $12.59 / $100.00
| Facility | | $10.47 | $12.59 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $10.47 / $29.51
| Professional | | $7.76 | $10.47 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $33.11 / $64.57
| Professional | | $6.61 | $33.11 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $15.85 / $36.31
| Facility | | $15.85 | $15.85 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $21.88 / $37.15
| Professional | | $10.00 | $21.88 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $33.88 / $67.61
| Professional | | $17.78 | $33.88 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $100.00
| Facility | | $31.62 | $31.62 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $13.18
| Professional | | $7.08 | $8.91 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $28.18
| Professional | | $19.95 | $19.95 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $63.10 / $81.28
| Professional | | $19.95 | $63.10 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $11.75 / $31.62
| Facility | | $6.61 | $11.75 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $10.47 / $29.51
| Professional | | $6.61 | $10.47 | $29.51 |