- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $58.88 / $288.40
| Facility | | $12.02 | $58.88 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.32 / $12.02
| Professional | | $7.08 | $8.32 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $43.65
| Facility | | $10.23 | $10.23 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $7.76
| Professional | | $5.01 | $5.01 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $47.86 / $72.44
| Professional | | $30.20 | $47.86 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $24.55 / $45.71
| Facility | | $10.47 | $24.55 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $7.41 / $17.78
| Professional | | $5.50 | $7.41 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.30 / $15.14
| Professional | | $10.23 | $12.30 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $16.98 / $19.95
| Professional | | $8.51 | $16.98 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $12.02
| Facility | | $8.91 | $8.91 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $21.38
| Professional | | $12.02 | $12.02 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $14.79 / $10,000.00
| Facility | | $7.94 | $14.79 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $14.79 / $10,000.00
| Professional | | $7.94 | $14.79 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $10.23 / $17.38
| Facility | | $4.27 | $10.23 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $6.17 / $11.22
| Professional | | $4.27 | $6.17 | $11.22 |