- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $51.29 / $134.90
| Facility | | $16.98 | $51.29 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $18.20 / $22.91
| Professional | | $16.98 | $18.20 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $15.85 / $97.72
| Facility | | $15.85 | $15.85 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $17.78
| Professional | | $10.96 | $10.96 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $104.71 / $158.49
| Professional | | $66.07 | $104.71 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $58.88 / $104.71
| Facility | | $23.44 | $58.88 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $23.44 / $60.26
| Professional | | $12.59 | $23.44 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $27.54 / $33.88
| Professional | | $22.91 | $27.54 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $37.15 / $43.65
| Professional | | $18.62 | $37.15 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $25.12 / $25.12
| Facility | | $21.38 | $25.12 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $30.90 / $48.98
| Professional | | $22.91 | $30.90 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $27.54 / $4,073.80
| Facility | | $15.14 | $27.54 | $4,073.80 |
- 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
- $8.51 / $22.91 / $38.02
| Facility | | $8.51 | $22.91 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $13.18 / $23.44
| Professional | | $9.77 | $13.18 | $23.44 |