- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $38.90 / $64.57
| Facility | | $14.13 | $38.90 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $14.13 / $30.20
| Professional | | $10.96 | $14.13 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $21.38 / $100.00
| Facility | | $13.80 | $21.38 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $15.14 / $36.31
| Professional | | $8.91 | $15.14 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $36.31 / $58.88
| Facility | | $29.51 | $36.31 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $19.05
| Professional | | $14.13 | $14.13 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $23.99 / $57.54
| Facility | | $11.75 | $23.99 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $16.98 / $38.90
| Professional | | $9.12 | $16.98 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $117.49 / $7,079.46
| Facility | | $17.38 | $117.49 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $21.38 / $25.12
| Professional | | $21.38 | $21.38 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $40.74
| Professional | | $15.14 | $15.14 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $21.38 / $100.00
| Facility | | $13.80 | $21.38 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $15.14 / $36.31
| Professional | | $8.91 | $15.14 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $15.14 / $21.88
| Facility | | $7.59 | $15.14 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.59 / $38.02
| Professional | | $8.91 | $12.59 | $38.02 |