- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $147.91 / $602.56
| Facility | | $12.02 | $147.91 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $15.14 / $19.95
| Professional | | $10.47 | $15.14 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $10.47 / $13.49
| Professional | | $10.47 | $10.47 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $18.62
| Facility | | $3.98 | $3.98 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $18.62 / $23.44
| Professional | | $3.98 | $18.62 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $37.15 / $37.15
| Facility | | $13.80 | $37.15 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $11.75
| Professional | | $11.75 | $11.75 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $44.67 / $100.00
| Facility | | $17.38 | $44.67 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $14.13 / $17.78
| Professional | | $5.13 | $14.13 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $14.79 / $36.31
| Professional | | $13.49 | $14.79 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.33 / $14.13
| Facility | | $7.41 | $9.33 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $11.22 / $14.13
| Professional | | $8.91 | $11.22 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $23.44
| Professional | | $13.49 | $13.49 | $23.44 |