- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $144.54 / $912.01
| Facility | | $33.11 | $144.54 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $46.77 / $144.54
| Professional | | $12.88 | $46.77 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $75.86
| Facility | | $17.78 | $17.78 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $13.80
| Professional | | $8.91 | $8.91 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $85.11 / $125.89
| Professional | | $53.70 | $85.11 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $44.67 / $81.28
| Facility | | $18.20 | $44.67 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $13.18 / $26.30
| Professional | | $9.77 | $13.18 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $21.38 / $26.30
| Professional | | $17.78 | $21.38 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $30.20 / $35.48
| Professional | | $9.55 | $30.20 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $18.62
| Facility | | $15.49 | $15.49 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $19.95 / $38.02
| Professional | | $18.62 | $19.95 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $30.20 / $10,000.00
| Facility | | $15.85 | $30.20 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $30.20 / $10,000.00
| Professional | | $15.85 | $30.20 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $17.78 / $30.90
| Facility | | $7.59 | $17.78 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $10.72 / $18.62
| Professional | | $7.59 | $10.72 | $18.62 |