- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $51.29 / $173.78
| Facility | | $19.05 | $51.29 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.30 / $27.54
| Professional | | $10.23 | $12.30 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $19.50 / $100.00
| Facility | | $12.59 | $19.50 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $13.80 / $33.11
| Professional | | $6.76 | $13.80 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $33.88 / $48.98
| Facility | | $26.92 | $33.88 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $12.88 / $17.38
| Professional | | $12.88 | $12.88 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $21.88 / $52.48
| Facility | | $10.72 | $21.88 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $15.85 / $36.31
| Professional | | $8.32 | $15.85 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $114.82 / $7,079.46
| Facility | | $15.85 | $114.82 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $19.50 / $22.91
| Professional | | $19.50 | $19.50 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $37.15
| Professional | | $13.80 | $13.80 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $24.55 / $141.25
| Facility | | $16.22 | $24.55 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $19.50 / $100.00
| Facility | | $12.59 | $19.50 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $13.80 / $33.11
| Professional | | $6.76 | $13.80 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $19.05 / $32.36
| Facility | | $13.80 | $19.05 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.13 / $20.42
| Professional | | $12.02 | $14.13 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $13.80 / $22.39
| Facility | | $7.94 | $13.80 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $11.48 / $37.15
| Professional | | $6.31 | $11.48 | $37.15 |