- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $70.79 / $234.42
| Facility | | $23.44 | $70.79 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.13 / $26.92
| Professional | | $12.02 | $14.13 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $48.98 / $53.70
| Facility | | $30.20 | $48.98 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $20.89 / $31.62
| Professional | | $9.33 | $20.89 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $41.69 / $47.86
| Professional | | $38.02 | $41.69 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $19.95 / $117.49
| Facility | | $18.62 | $19.95 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $21.38 / $27.54
| Professional | | $16.98 | $21.38 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $37.15
| Facility | | $18.62 | $18.62 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $20.42 / $26.30
| Professional | | $18.62 | $20.42 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $25.70 / $54.95
| Facility | | $16.60 | $25.70 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $20.89 / $79.43
| Professional | | $16.60 | $20.89 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $56.23 / $77.62
| Facility | | $28.18 | $56.23 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $16.98 / $22.39
| Professional | | $14.13 | $16.98 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $22.39 / $29.51
| Facility | | $8.32 | $22.39 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $22.39
| Professional | | $7.76 | $7.76 | $22.39 |