- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $40.74 / $177.83
| Facility | | $11.48 | $40.74 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- 25
- Typical Low / Median / Typical High
- $25.12 / $93.33 / $549.54
| Facility | 25 | $25.12 | $93.33 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $21.88 / $60.26
| Professional | | $7.08 | $21.88 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $21.38 / $38.90 / $79.43
| Professional | 25 | $21.38 | $38.90 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $20.89 / $53.70
| Professional | | $8.91 | $20.89 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $30.90 / $51.29
| Professional | | $8.51 | $30.90 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $19.50 / $37.15
| Facility | | $7.76 | $19.50 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $34.67 / $489.78
| Professional | | $20.42 | $34.67 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $23.99 / $23.99 / $100.00
| Professional | 25 | $23.99 | $23.99 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $37.15 / $56.23
| Professional | | $14.13 | $37.15 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $33.88 / $67.61
| Professional | | $12.88 | $33.88 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $22.91 / $50.12
| Professional | | $7.94 | $22.91 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $19.50 / $28.18
| Facility | | $8.71 | $19.50 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $23.44 / $57.54
| Professional | | $9.77 | $23.44 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $28.84 / $28.84 / $79.43
| Professional | 25 | $28.84 | $28.84 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $13.49 / $33.11
| Professional | | $10.47 | $13.49 | $33.11 |