- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $67.61 / $141.25
| Facility | | $21.38 | $67.61 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $15.85 / $64.57
| Professional | | $10.96 | $15.85 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $28.18 / $50.12
| Facility | | $28.18 | $28.18 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $19.05 / $29.51
| Professional | | $8.13 | $19.05 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $38.02 / $44.67
| Professional | | $35.48 | $38.02 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $87.10
| Facility | | $17.38 | $17.38 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $20.89 / $25.12
| Professional | | $17.38 | $20.89 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $34.67
| Facility | | $17.38 | $17.38 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $34.67
| Professional | | $17.38 | $17.38 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $23.99 / $51.29
| Facility | | $16.60 | $23.99 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $19.05 / $26.92
| Professional | | $15.49 | $19.05 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $51.29 / $70.79
| Facility | | $25.70 | $51.29 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.85 / $20.89
| Professional | | $12.88 | $15.85 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $20.89 / $27.54
| Facility | | $7.76 | $20.89 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $20.89
| Professional | | $7.24 | $7.24 | $20.89 |