- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $14.79 / $100.00
| Facility | | $7.94 | $14.79 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $12.88
| Professional | | $7.08 | $7.08 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $16.60 / $51.29
| Facility | | $7.08 | $16.60 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.08 / $7.08
| Professional | | $6.46 | $7.08 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.77 / $29.51
| Facility | | $7.41 | $9.77 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $7.94
| Professional | | $6.46 | $6.46 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.41 / $104.71
| Facility | | $6.46 | $7.41 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.41 / $107.15
| Professional | | $6.46 | $7.41 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.91 / $75.86
| Professional | | $8.13 | $8.91 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $16.98
| Facility | | $8.13 | $8.13 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.30 / $53.70
| Facility | | $8.91 | $12.30 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $8.91 / $8.91
| Professional | | $7.94 | $8.91 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $16.98 / $43.65
| Facility | | $10.72 | $16.98 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.08 / $7.08
| Professional | | $6.46 | $7.08 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $7.94 / $11.22
| Facility | | $3.09 | $7.94 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $7.41 / $11.48
| Professional | | $4.79 | $7.41 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $8.32
| Professional | | $6.46 | $6.46 | $8.32 |