- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $58.88 / $131.83
| Facility | | $16.60 | $58.88 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $9.12 / $22.39
| Professional | | $7.94 | $9.12 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $26.92 / $37.15
| Facility | | $16.60 | $26.92 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $11.75 / $19.50
| Professional | | $7.08 | $11.75 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $22.91 / $26.30
| Professional | | $21.38 | $22.91 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $26.30 / $100.00
| Facility | | $10.23 | $26.30 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.30 / $19.95
| Professional | | $8.91 | $12.30 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $20.89
| Facility | | $10.23 | $10.23 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $12.30
| Professional | | $10.23 | $10.23 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $14.45 / $30.90
| Facility | | $10.00 | $14.45 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.30 / $79.43
| Professional | | $10.23 | $12.30 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $30.90 / $42.66
| Facility | | $15.49 | $30.90 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $10.47 / $13.18
| Professional | | $7.76 | $10.47 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $12.30 / $16.60
| Facility | | $6.46 | $12.30 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.89 / $14.45
| Professional | | $4.37 | $5.89 | $14.45 |