- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $36.31 / $162.18
| Facility | | $15.49 | $36.31 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $18.20 / $100.00
| Professional | | $12.02 | $18.20 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $22.91 / $30.90
| Facility | | $16.22 | $22.91 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $13.80 / $15.49
| Professional | | $11.75 | $13.80 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $34.67 / $56.23
| Facility | | $16.22 | $34.67 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $16.22 / $23.44
| Professional | | $9.55 | $16.22 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $33.11 / $75.86
| Professional | | $15.49 | $33.11 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $31.62
| Facility | | $15.49 | $15.49 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $25.70 / $31.62
| Professional | | $15.49 | $25.70 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $26.92 / $42.66
| Facility | | $15.49 | $26.92 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $18.62
| Professional | | $13.80 | $13.80 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $23.44 / $40.74
| Facility | | $17.78 | $23.44 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $13.80 / $15.49
| Professional | | $11.75 | $13.80 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $18.62 / $18.62
| Facility | | $13.80 | $18.62 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $12.88 / $21.88
| Professional | | $9.33 | $12.88 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $7.94 / $28.18
| Professional | | $6.92 | $7.94 | $28.18 |