- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $31.62 / $6,918.31
| Facility | | $12.30 | $31.62 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.30 / $2,951.21
| Professional | | $12.02 | $12.30 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $13.18 / $5,011.87
| Facility | | $11.22 | $13.18 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.59 / $13.18
| Professional | | $12.30 | $12.59 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $42.66 / $45.71
| Facility | | $12.30 | $42.66 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $12.30
| Professional | | $12.30 | $12.30 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $12.30
| Facility | | $12.30 | $12.30 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $21.38 / $21.38
| Professional | | $18.20 | $21.38 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $21.38 / $31.62
| Facility | | $8.71 | $21.38 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $18.20 / $31.62
| Facility | | $12.88 | $18.20 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $18.20
| Professional | | $12.02 | $12.02 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $11.48 / $14.13
| Facility | | $8.32 | $11.48 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $11.48 / $14.13
| Professional | | $7.08 | $11.48 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $12.30
| Facility | | $12.30 | $12.30 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $16.60
| Professional | | $12.02 | $12.02 | $16.60 |