- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $58.88 / $199.53
| Facility | | $12.02 | $58.88 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $18.20
| Professional | | $10.00 | $10.00 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $58.88
| Facility | | $13.80 | $13.80 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $10.47
| Professional | | $6.76 | $6.76 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $69.18 / $97.72
| Professional | | $40.74 | $69.18 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $33.88 / $61.66
| Facility | | $14.13 | $33.88 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.00 / $23.44
| Professional | | $7.41 | $10.00 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $16.60 / $20.42
| Professional | | $13.80 | $16.60 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $22.91 / $26.92
| Professional | | $8.71 | $22.91 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $16.22
| Facility | | $12.30 | $12.30 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $16.22 / $28.84
| Professional | | $14.79 | $16.22 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $19.95 / $10,000.00
| Facility | | $12.30 | $19.95 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $19.95 / $10,000.00
| Professional | | $12.30 | $19.95 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $13.80 / $23.44
| Facility | | $5.75 | $13.80 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $8.32 / $14.45
| Professional | | $5.75 | $8.32 | $14.45 |