- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $39.81 / $97.72
| Facility | | $13.80 | $39.81 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.02 / $38.90
| Professional | | $10.00 | $12.02 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $19.50 / $109.65
| Facility | | $12.59 | $19.50 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $13.80 / $33.11
| Professional | | $6.76 | $13.80 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $33.88 / $48.98
| Facility | | $26.92 | $33.88 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $12.88 / $13.49
| Professional | | $12.88 | $12.88 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $21.88 / $52.48
| Facility | | $10.72 | $21.88 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $15.85 / $36.31
| Professional | | $8.32 | $15.85 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $66.07 / $7,079.46
| Facility | | $12.02 | $66.07 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $19.50 / $22.91
| Professional | | $19.50 | $19.50 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $32.36
| Professional | | $13.80 | $13.80 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $13.80
| Facility | | $13.80 | $13.80 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $19.50 / $109.65
| Facility | | $12.59 | $19.50 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $13.80 / $33.11
| Professional | | $6.76 | $13.80 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $13.80 / $19.95
| Facility | | $6.92 | $13.80 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $10.96 / $34.67
| Professional | | $5.50 | $10.96 | $34.67 |