- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $56.23 / $151.36
| Facility | | $25.70 | $56.23 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $23.99 / $38.02
| Professional | | $16.98 | $23.99 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $38.02 / $51.29
| Facility | | $26.92 | $38.02 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $23.44 / $25.70
| Professional | | $19.50 | $23.44 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $57.54 / $83.18
| Facility | | $26.92 | $57.54 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $27.54 / $40.74
| Professional | | $15.85 | $27.54 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $22.91 / $64.57
| Professional | | $16.60 | $22.91 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $52.48
| Facility | | $25.70 | $25.70 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $25.70 / $30.90
| Professional | | $22.91 | $25.70 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $44.67 / $79.43
| Facility | | $25.70 | $44.67 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $23.44 / $30.90
| Professional | | $23.44 | $23.44 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $38.90 / $67.61
| Facility | | $29.51 | $38.90 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $23.44 / $25.70
| Professional | | $19.50 | $23.44 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $30.90 / $30.90
| Facility | | $23.44 | $30.90 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $15.14 / $33.11
| Professional | | $10.96 | $15.14 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $13.49 / $46.77
| Professional | | $11.48 | $13.49 | $46.77 |