- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $47.86 / $194.98
| Facility | | $13.18 | $47.86 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $12.02 / $18.20
| Professional | | $7.08 | $12.02 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $9.12
| Professional | | $7.94 | $7.94 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $19.50 / $26.30
| Facility | | $13.80 | $19.50 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.02 / $13.18
| Professional | | $10.00 | $12.02 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $29.51 / $47.86
| Facility | | $13.80 | $29.51 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $13.80 / $19.05
| Professional | | $8.13 | $13.80 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $11.75 / $14.13
| Professional | | $8.51 | $11.75 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $26.92
| Facility | | $13.18 | $13.18 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $23.44 / $36.31
| Facility | | $13.18 | $23.44 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $15.85
| Professional | | $12.02 | $12.02 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $19.95 / $35.48
| Facility | | $15.14 | $19.95 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.02 / $13.18
| Professional | | $10.00 | $12.02 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $15.85 / $15.85
| Facility | | $12.02 | $15.85 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $7.59 / $18.20
| Professional | | $5.62 | $7.59 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.92 / $23.99
| Professional | | $6.03 | $6.92 | $23.99 |