- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $28.84 / $141.25
| Facility | | $14.45 | $28.84 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.96 / $14.45
| Professional | | $10.00 | $10.96 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $61.66
| Facility | | $14.45 | $14.45 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $5.89 / $9.77
| Professional | | $5.89 | $5.89 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $56.23 / $77.62
| Professional | | $32.36 | $56.23 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $28.18 / $66.07
| Facility | | $14.79 | $28.18 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $19.05
| Professional | | $7.08 | $8.91 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $17.38 / $21.38
| Professional | | $14.45 | $17.38 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $18.20 / $21.38
| Professional | | $3.39 | $18.20 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $17.78
| Facility | | $10.72 | $10.72 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $28.18 / $30.90
| Professional | | $28.18 | $28.18 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $19.05 / $10,000.00
| Facility | | $10.72 | $19.05 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $19.05 / $10,000.00
| Professional | | $10.72 | $19.05 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $14.45 / $18.62
| Facility | | $6.17 | $14.45 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $7.24 / $14.45
| Professional | | $6.17 | $7.24 | $14.45 |