- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $43.65 / $100.00
| Facility | | $16.98 | $43.65 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $11.22 / $32.36
| Professional | | $7.94 | $11.22 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $17.38 / $112.20
| Facility | | $11.22 | $17.38 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $12.30 / $30.20
| Professional | | $6.17 | $12.30 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $30.20 / $43.65
| Facility | | $23.99 | $30.20 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $12.02
| Professional | | $11.75 | $11.75 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $19.50 / $47.86
| Facility | | $9.55 | $19.50 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $14.13 / $32.36
| Professional | | $7.59 | $14.13 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $57.54 / $7,079.46
| Facility | | $10.47 | $57.54 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $20.89
| Professional | | $17.78 | $17.78 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $28.84
| Professional | | $12.30 | $12.30 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $24.55 / $117.49
| Facility | | $12.02 | $24.55 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $17.38 / $112.20
| Facility | | $11.22 | $17.38 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $12.30 / $30.20
| Professional | | $6.17 | $12.30 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $12.59 / $23.44
| Facility | | $9.55 | $12.59 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $10.96 / $18.62
| Professional | | $9.55 | $10.96 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $12.30 / $18.20
| Facility | | $6.17 | $12.30 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $9.55 / $31.62
| Professional | | $5.25 | $9.55 | $31.62 |