- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $36.31 / $87.10
| Facility | | $10.96 | $36.31 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $9.77
| Professional | | $6.03 | $7.08 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $11.48 / $100.00
| Facility | | $7.41 | $11.48 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $8.13 / $19.50
| Professional | | $4.17 | $8.13 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $19.95 / $32.36
| Facility | | $16.22 | $19.95 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $10.47
| Professional | | $7.59 | $7.59 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $12.88 / $30.90
| Facility | | $6.31 | $12.88 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $9.55 / $20.89
| Professional | | $5.01 | $9.55 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $64.57 / $7,079.46
| Facility | | $9.33 | $64.57 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $13.80
| Professional | | $11.75 | $11.75 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $21.88
| Professional | | $8.13 | $8.13 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $13.49 / $48.98
| Facility | | $9.55 | $13.49 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $11.48 / $100.00
| Facility | | $7.41 | $11.48 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $8.13 / $19.50
| Professional | | $4.17 | $8.13 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $9.77 / $19.05
| Facility | | $7.08 | $9.77 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.32 / $12.02
| Professional | | $7.08 | $8.32 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.13 / $12.02
| Facility | | $4.07 | $8.13 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $6.76 / $21.88
| Professional | | $4.17 | $6.76 | $21.88 |