- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $28.84 / $46.77
| Facility | | $10.00 | $28.84 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $21.88
| Professional | | $7.94 | $10.00 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.49 / $100.00
| Facility | | $10.00 | $15.49 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $12.59 / $30.90
| Professional | | $5.50 | $12.59 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $26.92 / $38.90
| Facility | | $21.88 | $26.92 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $14.13
| Professional | | $12.02 | $12.02 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $17.38 / $42.66
| Facility | | $8.91 | $17.38 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $14.45 / $33.11
| Professional | | $7.76 | $14.45 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $56.23 / $7,079.46
| Facility | | $10.23 | $56.23 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $21.38
| Professional | | $18.20 | $18.20 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $30.90
| Professional | | $12.59 | $12.59 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.49 / $100.00
| Facility | | $10.00 | $15.49 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $12.59 / $30.90
| Professional | | $5.50 | $12.59 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $12.59 / $18.20
| Facility | | $6.31 | $12.59 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $9.77 / $28.84
| Professional | | $5.01 | $9.77 | $28.84 |