- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $30.20 / $52.48
| Facility | | $10.00 | $30.20 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.88 / $46.77
| Professional | | $10.00 | $12.88 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $18.20 / $75.86
| Facility | | $11.75 | $18.20 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $16.22 / $38.90
| Professional | | $9.55 | $16.22 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $32.36 / $47.86
| Facility | | $25.70 | $32.36 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $15.14 / $15.85
| Professional | | $14.79 | $15.14 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $20.89 / $46.77
| Facility | | $11.22 | $20.89 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $18.62 / $41.69
| Professional | | $9.12 | $18.62 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $117.49 / $7,079.46
| Facility | | $13.18 | $117.49 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $23.44 / $27.54
| Professional | | $23.44 | $23.44 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $36.31
| Professional | | $16.22 | $16.22 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $18.20 / $75.86
| Facility | | $11.75 | $18.20 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $16.22 / $38.90
| Professional | | $9.55 | $16.22 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $15.14 / $19.50
| Facility | | $7.24 | $15.14 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $16.22 / $37.15
| Professional | | $9.55 | $16.22 | $37.15 |