- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $38.02 / $138.04
| Facility | | $14.13 | $38.02 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.80 / $14.13
| Professional | | $10.96 | $13.80 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $66.07
| Facility | | $15.49 | $15.49 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $11.75
| Professional | | $7.59 | $7.59 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $77.62 / $107.15
| Professional | | $45.71 | $77.62 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $37.15 / $69.18
| Facility | | $15.85 | $37.15 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $11.22 / $26.30
| Professional | | $8.32 | $11.22 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $18.62 / $22.91
| Professional | | $15.49 | $18.62 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $25.70 / $30.20
| Professional | | $12.88 | $25.70 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $25.12
| Facility | | $13.80 | $13.80 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $32.36
| Professional | | $12.30 | $12.30 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $22.39 / $10,000.00
| Facility | | $12.02 | $22.39 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $21.88 / $10,000.00
| Professional | | $12.02 | $21.88 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $15.49 / $26.30
| Facility | | $6.46 | $15.49 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $9.33 / $16.22
| Professional | | $6.46 | $9.33 | $16.22 |