- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $39.81 / $177.83
| Facility | | $13.80 | $39.81 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.02 / $56.23
| Professional | | $10.00 | $12.02 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $17.78 / $151.36
| Facility | | $11.48 | $17.78 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $13.80 / $33.88
| Professional | | $6.17 | $13.80 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $30.90 / $48.98
| Facility | | $24.55 | $30.90 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $12.88 / $15.85
| Professional | | $12.88 | $12.88 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $19.95 / $47.86
| Facility | | $10.00 | $19.95 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $16.22 / $36.31
| Professional | | $8.32 | $16.22 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $97.72 / $7,079.46
| Facility | | $14.45 | $97.72 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $23.44
| Professional | | $19.95 | $19.95 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $33.88
| Professional | | $13.80 | $13.80 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $39.81 / $302.00
| Facility | | $13.18 | $39.81 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $17.78 / $151.36
| Facility | | $11.48 | $17.78 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $13.80 / $33.88
| Professional | | $6.17 | $13.80 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $13.80 / $18.20
| Facility | | $6.92 | $13.80 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $10.96 / $33.88
| Professional | | $5.50 | $10.96 | $33.88 |