- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $18.62 / $31.62
| Facility | | $6.03 | $18.62 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.94 / $14.13
| Professional | | $6.03 | $7.94 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $12.59 / $100.00
| Facility | | $8.13 | $12.59 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $9.77 / $23.99
| Professional | | $5.62 | $9.77 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $22.39 / $31.62
| Facility | | $17.78 | $22.39 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $9.33 / $9.55
| Professional | | $8.91 | $9.33 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $14.13 / $34.67
| Facility | | $7.24 | $14.13 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $11.22 / $31.62
| Professional | | $6.17 | $11.22 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $13.18 / $4,897.79
| Facility | | $10.00 | $13.18 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $12.88 / $16.60
| Professional | | $10.72 | $12.88 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $22.91
| Professional | | $9.77 | $9.77 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $12.59 / $100.00
| Facility | | $8.13 | $12.59 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $9.77 / $23.99
| Professional | | $5.62 | $9.77 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $9.77 / $14.45
| Facility | | $5.13 | $9.77 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $9.77 / $25.12
| Professional | | $4.47 | $9.77 | $25.12 |