- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $39.81 / $77.62
| Facility | | $12.88 | $39.81 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $14.13 / $26.92
| Professional | | $12.88 | $14.13 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $77.62
| Facility | | $18.20 | $18.20 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $10.96 / $13.80
| Professional | | $9.12 | $10.96 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $61.66 / $91.20
| Professional | | $38.02 | $61.66 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $34.67 / $81.28
| Facility | | $18.62 | $34.67 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $13.80 / $22.39
| Professional | | $8.71 | $13.80 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $21.88 / $26.92
| Professional | | $18.20 | $21.88 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $21.88 / $25.12
| Professional | | $10.72 | $21.88 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $18.20
| Facility | | $10.96 | $10.96 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $16.22 / $38.02
| Professional | | $13.49 | $16.22 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $23.99 / $10,000.00
| Facility | | $14.45 | $23.99 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $23.99 / $10,000.00
| Professional | | $14.45 | $23.99 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $18.20 / $22.39
| Facility | | $7.59 | $18.20 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $11.22 / $18.20
| Professional | | $10.47 | $11.22 | $18.20 |