- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $39.81 / $79.43
| Facility | | $12.88 | $39.81 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.88 / $16.98
| Professional | | $12.02 | $12.88 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $77.62
| Facility | | $18.20 | $18.20 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $12.30
| Professional | | $7.24 | $7.24 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $67.61 / $93.33
| Professional | | $38.90 | $67.61 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $35.48 / $83.18
| Facility | | $18.62 | $35.48 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $10.72 / $22.91
| Professional | | $8.71 | $10.72 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $21.88 / $26.92
| Professional | | $18.20 | $21.88 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $21.88 / $25.70
| Professional | | $10.96 | $21.88 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.18 / $15.49
| Facility | | $10.96 | $13.18 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $38.02 / $45.71
| Professional | | $10.96 | $38.02 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $22.91 / $10,000.00
| Facility | | $13.18 | $22.91 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $23.44 / $10,000.00
| Professional | | $13.18 | $23.44 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $18.20 / $22.91
| Facility | | $7.59 | $18.20 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $8.32 / $18.20
| Professional | | $7.59 | $8.32 | $18.20 |