- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $37.15 / $53.70
| Facility | | $10.00 | $37.15 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.88 / $23.99
| Professional | | $10.00 | $12.88 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $18.62 / $77.62
| Facility | | $12.02 | $18.62 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $16.60 / $39.81
| Professional | | $9.55 | $16.60 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $33.11 / $47.86
| Facility | | $26.30 | $33.11 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $15.49 / $16.22
| Professional | | $14.79 | $15.49 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $21.38 / $46.77
| Facility | | $11.48 | $21.38 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $19.05 / $42.66
| Professional | | $9.12 | $19.05 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $91.20 / $7,079.46
| Facility | | $13.18 | $91.20 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $23.99 / $28.18
| Professional | | $23.99 | $23.99 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $37.15
| Professional | | $16.60 | $16.60 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $18.62 / $77.62
| Facility | | $12.02 | $18.62 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $16.60 / $39.81
| Professional | | $9.55 | $16.60 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $15.14 / $19.50
| Facility | | $7.41 | $15.14 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $16.60 / $38.02
| Professional | | $9.55 | $16.60 | $38.02 |