- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $56.23 / $144.54
| Facility | | $10.00 | $56.23 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.24 / $22.91
| Professional | | $6.03 | $7.24 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.62 / $11.48
| Professional | | $5.37 | $5.62 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $17.78 / $25.70
| Facility | | $16.98 | $17.78 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $7.41
| Professional | | $6.03 | $6.03 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $16.98 / $37.15
| Facility | | $5.62 | $16.98 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $6.31 / $12.30
| Professional | | $4.17 | $6.31 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $14.13 / $20.42
| Professional | | $6.76 | $14.13 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.08 / $15.85
| Facility | | $6.46 | $7.08 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $10.72 / $10.72
| Professional | | $6.46 | $10.72 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $2,630.27 / $2,951.21
| Facility | | $2,398.83 | $2,630.27 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $8.13 / $14.13
| Facility | | $4.27 | $8.13 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.62 / $11.22
| Professional | | $4.07 | $5.62 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $60.26
| Facility | | $60.26 | $60.26 | $60.26 |