- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $57.54 / $169.82
| Facility | | $17.78 | $57.54 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $12.02 / $20.42
| Professional | | $7.08 | $12.02 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $34.67 / $47.86
| Facility | | $21.38 | $34.67 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $14.79 / $25.12
| Professional | | $8.32 | $14.79 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $29.51 / $33.88
| Professional | | $27.54 | $29.51 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $134.90
| Facility | | $13.18 | $13.18 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $15.85 / $20.42
| Professional | | $13.18 | $15.85 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $26.92
| Facility | | $13.18 | $13.18 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $15.85
| Professional | | $13.18 | $13.18 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $18.62 / $38.90
| Facility | | $12.88 | $18.62 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.79 / $25.70
| Professional | | $12.02 | $14.79 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $39.81 / $54.95
| Facility | | $19.95 | $39.81 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $13.49 / $18.20
| Professional | | $10.00 | $13.49 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $15.85 / $21.38
| Facility | | $8.13 | $15.85 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $7.59 / $18.20
| Professional | | $5.62 | $7.59 | $18.20 |