- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $56.23 / $147.91
| Facility | | $25.70 | $56.23 | $147.91 |
- 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
- $19.05 / $22.91 / $25.70
| Professional | | $19.05 | $22.91 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $56.23 / $79.43
| Facility | | $26.30 | $56.23 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $26.92 / $38.90
| Professional | | $15.49 | $26.92 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $22.39 / $64.57
| Professional | | $16.22 | $22.39 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $51.29
| Facility | | $25.70 | $25.70 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $25.70
| Professional | | $25.70 | $25.70 | $25.70 |
- 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
- $22.91 / $22.91 / $30.90
| Professional | | $22.91 | $22.91 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $38.02 / $67.61
| Facility | | $29.51 | $38.02 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $22.91 / $25.70
| Professional | | $19.05 | $22.91 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $30.90 / $30.90
| Facility | | $22.91 | $30.90 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $14.79 / $31.62
| Professional | | $10.72 | $14.79 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $13.18 / $45.71
| Professional | | $11.48 | $13.18 | $45.71 |