- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $36.31 / $12,022.64
| Facility | | $5.01 | $36.31 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $7.94 / $32.36
| Professional | | $4.79 | $7.94 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.88 / $43.65
| Professional | | $10.96 | $12.88 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $15.49 / $38.90
| Facility | | $12.02 | $15.49 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $14.13 / $16.60
| Professional | | $11.75 | $14.13 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $33.88 / $58.88
| Professional | | $22.91 | $33.88 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $7.41
| Professional | | $7.41 | $7.41 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $52.48 / $154.88
| Professional | | $25.12 | $52.48 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $89.13 / $89.13
| Facility | | $89.13 | $89.13 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $100.00 / $100.00
| Professional | | $15.14 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Professional | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $70.79
| Professional | | $54.95 | $54.95 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $15.49 / $24.55
| Facility | | $7.59 | $15.49 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $7.41
| Professional | | $7.41 | $7.41 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.59 / $14.45
| Professional | | $5.01 | $7.59 | $14.45 |