- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $19.95 / $52.48
| Facility | | $12.02 | $19.95 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.02 / $18.20
| Professional | | $10.00 | $12.02 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $35.48 / $64.57
| Facility | | $28.18 | $35.48 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.96 / $19.05
| Professional | | $7.08 | $10.96 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $33.11 / $72.44
| Facility | | $10.72 | $33.11 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $10.47 / $23.99
| Professional | | $7.59 | $10.47 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $25.70 / $28.18
| Professional | | $9.55 | $25.70 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $13.18 / $28.18
| Facility | | $12.02 | $13.18 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $19.05 / $19.05
| Professional | | $11.75 | $19.05 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $19.05 / $25.70
| Facility | | $7.94 | $19.05 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.23 / $21.38
| Professional | | $7.94 | $10.23 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |