- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $54.95 / $134.90
| Facility | | $12.59 | $54.95 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.76 / $25.12
| Professional | | $6.03 | $7.76 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $12.02 / $100.00
| Facility | | $7.94 | $12.02 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $8.71 / $20.89
| Professional | | $5.13 | $8.71 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $21.38 / $34.67
| Facility | | $17.38 | $21.38 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $10.96
| Professional | | $8.13 | $8.13 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $13.80 / $33.11
| Facility | | $6.76 | $13.80 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $10.00 / $22.39
| Professional | | $5.13 | $10.00 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $67.61 / $7,079.46
| Facility | | $9.77 | $67.61 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $14.79
| Professional | | $12.59 | $12.59 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $23.44
| Professional | | $8.71 | $8.71 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $12.88 / $89.13
| Facility | | $10.47 | $12.88 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $12.02 / $100.00
| Facility | | $7.94 | $12.02 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $8.71 / $20.89
| Professional | | $5.13 | $8.71 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $9.77 / $19.50
| Facility | | $7.59 | $9.77 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $8.71 / $12.88
| Professional | | $7.59 | $8.71 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $8.71 / $14.13
| Facility | | $4.27 | $8.71 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $7.24 / $23.44
| Professional | | $5.13 | $7.24 | $23.44 |