- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $51.29 / $89.13
| Facility | | $18.20 | $51.29 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $18.20 / $33.88
| Professional | | $15.85 | $18.20 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $23.99 / $102.33
| Facility | | $23.99 | $23.99 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $9.55 / $16.22
| Professional | | $9.55 | $9.55 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $89.13 / $123.03
| Professional | | $52.48 | $89.13 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $46.77 / $107.15
| Facility | | $24.55 | $46.77 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $14.45 / $30.20
| Professional | | $11.48 | $14.45 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $28.84 / $35.48
| Professional | | $23.99 | $28.84 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $29.51 / $34.67
| Professional | | $14.79 | $29.51 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $28.84
| Facility | | $17.38 | $17.38 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $50.12
| Professional | | $16.98 | $16.98 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $28.84 / $10,000.00
| Facility | | $16.22 | $28.84 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $28.84 / $10,000.00
| Professional | | $16.22 | $28.84 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $23.99 / $30.20
| Facility | | $10.00 | $23.99 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.96 / $21.38
| Professional | | $10.00 | $10.96 | $21.38 |