- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $74.13 / $380.19
| Facility | | $13.18 | $74.13 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $8.91 / $24.55
| Professional | | $7.94 | $8.91 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $45.71
| Facility | | $10.72 | $10.72 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $8.32
| Professional | | $5.37 | $5.37 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $30.90 / $43.65
| Professional | | $18.20 | $30.90 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $26.92 / $48.98
| Facility | | $10.96 | $26.92 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $7.94 / $19.05
| Professional | | $5.89 | $7.94 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $12.88 / $15.85
| Professional | | $10.72 | $12.88 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $18.20 / $21.38
| Professional | | $8.91 | $18.20 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $17.38
| Facility | | $9.77 | $9.77 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $21.88 / $22.91
| Professional | | $21.88 | $21.88 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $18.20 / $10,000.00
| Facility | | $8.51 | $18.20 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $18.62 / $10,000.00
| Professional | | $8.51 | $18.62 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $10.72 / $18.62
| Facility | | $4.57 | $10.72 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $5.37 / $9.77
| Professional | | $3.63 | $5.37 | $9.77 |