- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $38.90 / $58.88
| Facility | | $20.42 | $38.90 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $22.91 / $38.90
| Professional | | $19.05 | $22.91 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $26.92 / $46.77
| Facility | | $23.44 | $26.92 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $15.85 / $33.11
| Professional | | $12.30 | $15.85 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $29.51
| Facility | | $16.98 | $16.98 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $34.67 / $34.67
| Professional | | $34.67 | $34.67 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $33.11 / $104.71
| Facility | | $16.98 | $33.11 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $16.60 / $47.86
| Professional | | $12.59 | $16.60 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $95.50
| Facility | | $16.60 | $16.60 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $16.22 / $34.67
| Professional | | $12.59 | $16.22 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $22.91 / $31.62
| Professional | | $19.05 | $22.91 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $30.90 / $30.90
| Facility | | $30.90 | $30.90 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $26.92 / $52.48
| Professional | | $17.78 | $26.92 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $25.70 / $38.02
| Facility | | $12.59 | $25.70 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $15.49 / $30.90
| Professional | | $10.72 | $15.49 | $30.90 |