- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $1,288.25 / $1,949.84
| Facility | | $10.96 | $1,288.25 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $21.38 / $53.70
| Professional | | $12.88 | $21.38 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $15.49 / $22.91
| Professional | | $12.59 | $15.49 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $20.42 / $32.36
| Facility | | $11.22 | $20.42 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $14.45 / $16.60
| Professional | | $11.22 | $14.45 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $22.91 / $22.91
| Facility | | $22.91 | $22.91 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $18.20
| Facility | 52 | $18.20 | $18.20 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $19.50 / $40.74
| Professional | | $12.59 | $19.50 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.79 / $14.79
| Facility | | $14.13 | $14.79 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $10.23 / $18.20
| Professional | | $6.76 | $10.23 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $27.54 / $33.11
| Professional | | $12.30 | $27.54 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $15.49 / $31.62
| Professional | | $10.96 | $15.49 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $14.45
| Professional | | $10.72 | $10.72 | $14.45 |