- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $37.15 / $128.82
| Facility | | $12.02 | $37.15 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.88 / $15.85
| Professional | | $12.02 | $12.88 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $72.44
| Facility | | $16.98 | $16.98 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $12.02
| Professional | | $7.08 | $7.08 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $72.44 / $100.00
| Professional | | $41.69 | $72.44 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $37.15 / $77.62
| Facility | | $17.38 | $37.15 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.96 / $25.12
| Professional | | $8.32 | $10.96 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $20.42 / $25.12
| Professional | | $16.98 | $20.42 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $16.98
| Facility | | $12.30 | $12.30 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $35.48
| Professional | | $11.48 | $11.48 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $22.39 / $10,000.00
| Facility | | $12.59 | $22.39 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $22.39 / $10,000.00
| Professional | | $12.59 | $22.39 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $16.98 / $23.99
| Facility | | $7.08 | $16.98 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.51 / $16.98
| Professional | | $7.08 | $8.51 | $16.98 |