- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $75.86 / $125.89
| Facility | | $15.14 | $75.86 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $12.30
| Professional | | $7.08 | $8.91 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $43.65
| Facility | | $10.23 | $10.23 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $7.94
| Professional | | $5.13 | $5.13 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $52.48 / $72.44
| Professional | | $30.90 | $52.48 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $26.92 / $47.86
| Facility | | $10.47 | $26.92 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.59 / $18.20
| Professional | | $5.75 | $7.59 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.30 / $15.14
| Professional | | $10.23 | $12.30 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $17.38 / $20.42
| Professional | | $8.51 | $17.38 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $16.60
| Facility | | $8.91 | $8.91 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $21.88
| Professional | | $10.00 | $10.00 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $16.60 / $10,000.00
| Facility | | $9.12 | $16.60 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $17.38 / $10,000.00
| Professional | | $9.12 | $17.38 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $10.23 / $17.78
| Facility | | $4.37 | $10.23 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.17 / $10.72
| Professional | | $4.37 | $6.17 | $10.72 |