- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $39.81 / $218.78
| Facility | | $17.78 | $39.81 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.59 / $26.92
| Professional | | $10.00 | $12.59 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $61.66
| Facility | | $14.45 | $14.45 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $10.96
| Professional | | $7.08 | $7.08 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $72.44 / $102.33
| Professional | | $42.66 | $72.44 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $36.31 / $64.57
| Facility | | $14.79 | $36.31 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $10.47 / $25.12
| Professional | | $7.76 | $10.47 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $17.38 / $21.38
| Professional | | $14.45 | $17.38 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $23.99 / $28.18
| Professional | | $12.02 | $23.99 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $16.98
| Facility | | $13.18 | $13.18 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $16.98 / $30.20
| Professional | | $10.72 | $16.98 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $22.39 / $10,000.00
| Facility | | $12.88 | $22.39 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $22.39 / $10,000.00
| Professional | | $12.88 | $22.39 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $14.45 / $24.55
| Facility | | $6.03 | $14.45 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.71 / $15.14
| Professional | | $6.03 | $8.71 | $15.14 |