- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $97.72 / $776.25
| Facility | | $19.05 | $97.72 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.49 / $323.59
| Professional | | $10.96 | $13.49 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $63.10
| Facility | | $15.14 | $15.14 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $11.48
| Professional | | $7.41 | $7.41 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $70.79 / $104.71
| Professional | | $44.67 | $70.79 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $38.90 / $67.61
| Facility | | $15.14 | $38.90 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $10.96 / $21.38
| Professional | | $8.13 | $10.96 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $17.78 / $22.39
| Professional | | $15.14 | $17.78 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $25.12 / $29.51
| Professional | | $12.30 | $25.12 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $15.49
| Facility | | $13.18 | $13.18 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $15.49 / $31.62
| Professional | | $10.72 | $15.49 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $25.12 / $10,000.00
| Facility | | $13.18 | $25.12 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $25.70 / $10,000.00
| Professional | | $13.18 | $25.70 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $15.14 / $25.70
| Facility | | $6.31 | $15.14 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $8.91 / $16.60
| Professional | | $6.31 | $8.91 | $16.60 |