- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $43.65 / $70.79
| Facility | | $15.14 | $43.65 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $15.14 / $33.11
| Professional | | $12.02 | $15.14 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $23.44 / $79.43
| Facility | | $15.14 | $23.44 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $16.60 / $40.74
| Professional | | $10.00 | $16.60 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $40.74 / $58.88
| Facility | | $32.36 | $40.74 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $15.85 / $21.38
| Professional | | $15.85 | $15.85 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $26.92 / $64.57
| Facility | | $13.18 | $26.92 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $19.50 / $43.65
| Professional | | $10.23 | $19.50 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $138.04 / $7,079.46
| Facility | | $19.05 | $138.04 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $24.55 / $28.84
| Professional | | $24.55 | $24.55 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $45.71
| Professional | | $16.60 | $16.60 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $23.44 / $79.43
| Facility | | $15.14 | $23.44 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $16.60 / $40.74
| Professional | | $10.00 | $16.60 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $16.60 / $24.55
| Facility | | $8.32 | $16.60 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $16.60 / $45.71
| Professional | | $10.00 | $16.60 | $45.71 |