- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $21.38 / $87.10
| Facility | | $9.55 | $21.38 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $6.03 / $13.80
| Professional | | $4.90 | $6.03 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $9.77 / $100.00
| Facility | | $6.31 | $9.77 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $7.41 / $18.20
| Professional | | $4.47 | $7.41 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $17.38 / $27.54
| Facility | | $13.80 | $17.38 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $8.91
| Professional | | $7.08 | $7.08 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $10.96 / $26.92
| Facility | | $5.50 | $10.96 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $8.71 / $19.95
| Professional | | $4.57 | $8.71 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $57.54 / $7,079.46
| Facility | | $7.94 | $57.54 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $12.59
| Professional | | $10.72 | $10.72 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $19.05
| Professional | | $7.41 | $7.41 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $15.14 / $100.00
| Facility | | $6.46 | $15.14 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $9.77 / $100.00
| Facility | | $6.31 | $9.77 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $7.41 / $18.20
| Professional | | $4.47 | $7.41 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $7.41 / $11.22
| Facility | | $3.98 | $7.41 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $7.41 / $18.62
| Professional | | $4.47 | $7.41 | $18.62 |