- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $19.05 / $54.95
| Facility | | $12.88 | $19.05 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.88 / $19.05
| Professional | | $10.00 | $12.88 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $58.88 / $58.88
| Facility | | $36.31 | $58.88 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.72 / $18.20
| Professional | | $7.41 | $10.72 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $34.67 / $75.86
| Facility | | $11.22 | $34.67 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $10.00 / $23.44
| Professional | | $7.76 | $10.00 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $25.70 / $102.33
| Professional | | $11.48 | $25.70 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.30 / $26.92
| Facility | | $10.00 | $12.30 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $16.60 / $18.20
| Professional | | $11.22 | $16.60 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $102.33 / $316.23
| Facility | | $102.33 | $102.33 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $16.60 / $23.99
| Facility | | $7.24 | $16.60 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $10.00 / $19.50
| Professional | | $6.92 | $10.00 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $87.10 / $89.13
| Facility | | $87.10 | $87.10 | $89.13 |