- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $25.70 / $41.69
| Facility | | $16.22 | $25.70 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.88 / $19.95
| Professional | | $10.96 | $12.88 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $13.49 / $22.39
| Professional | | $11.22 | $13.49 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $19.95
| Facility | | $17.38 | $17.38 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $269.15 / $478.63
| Professional | | $20.89 | $269.15 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $20.89 / $87.10
| Facility | | $13.49 | $20.89 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $19.95 / $24.55
| Professional | | $11.22 | $19.95 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $36.31
| Facility | | $11.22 | $11.22 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $11.22
| Professional | | $11.22 | $11.22 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $30.20
| Professional | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $20.89 / $20.89
| Facility | | $20.89 | $20.89 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $18.20 / $34.67
| Professional | | $12.02 | $18.20 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $17.38 / $25.70
| Facility | | $8.71 | $17.38 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $10.47 / $17.38
| Professional | | $7.24 | $10.47 | $17.38 |