- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $53.70 / $91.20
| Facility | | $18.20 | $53.70 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $18.20 / $22.91
| Professional | | $10.00 | $18.20 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $24.55 / $104.71
| Facility | | $24.55 | $24.55 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $16.60
| Professional | | $9.77 | $9.77 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $56.23 / $77.62
| Professional | | $32.36 | $56.23 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $40.74 / $112.20
| Facility | | $23.99 | $40.74 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $12.59 / $28.18
| Professional | | $7.76 | $12.59 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $29.51 / $36.31
| Professional | | $24.55 | $29.51 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $19.95 / $23.44
| Professional | | $10.00 | $19.95 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $24.55
| Facility | | $17.78 | $17.78 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.51 / $51.29
| Professional | | $8.51 | $8.51 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $28.84 / $10,000.00
| Facility | | $17.38 | $28.84 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $28.84 / $10,000.00
| Professional | | $17.38 | $28.84 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $24.55 / $29.51
| Facility | | $10.00 | $24.55 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $10.23 / $16.60
| Professional | | $6.46 | $10.23 | $16.60 |