- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $19.05 / $54.95
| Facility | | $15.49 | $19.05 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $19.05
| Professional | | $7.94 | $10.96 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $32.36 / $39.81
| Facility | | $19.95 | $32.36 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $13.80 / $22.39
| Professional | | $7.59 | $13.80 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $26.92 / $31.62
| Professional | | $25.12 | $26.92 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $19.05
| Facility | | $12.30 | $12.30 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $15.14 / $22.39
| Professional | | $12.30 | $15.14 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $24.55
| Facility | | $12.30 | $12.30 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $22.91
| Professional | | $12.30 | $12.30 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $16.98 / $36.31
| Facility | | $12.02 | $16.98 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $14.45 / $79.43
| Professional | | $11.22 | $14.45 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $37.15 / $51.29
| Facility | | $18.62 | $37.15 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $11.48 / $14.79
| Professional | | $9.12 | $11.48 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $14.79 / $19.50
| Facility | | $7.08 | $14.79 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.31 / $15.49
| Professional | | $5.13 | $6.31 | $15.49 |