- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $53.70 / $120.23
| Facility | | $13.80 | $53.70 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $26.30
| Professional | | $7.94 | $10.00 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $47.86
| Facility | | $11.22 | $11.22 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $8.71
| Professional | | $5.62 | $5.62 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $57.54 / $79.43
| Professional | | $33.11 | $57.54 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $28.84 / $50.12
| Facility | | $11.48 | $28.84 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $8.32 / $19.95
| Professional | | $6.17 | $8.32 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $13.49 / $16.60
| Professional | | $11.22 | $13.49 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $19.05 / $21.88
| Professional | | $9.33 | $19.05 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $13.18
| Facility | | $10.23 | $10.23 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.18 / $23.44
| Professional | | $10.96 | $13.18 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $19.05 / $10,000.00
| Facility | | $10.00 | $19.05 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $19.05 / $10,000.00
| Professional | | $10.00 | $19.05 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $11.22 / $19.50
| Facility | | $4.68 | $11.22 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.76 / $11.75
| Professional | | $4.68 | $6.76 | $11.75 |