- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $52.48 / $83.18
| Facility | | $23.99 | $52.48 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $13.49 / $21.88
| Professional | | $12.02 | $13.49 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $48.98 / $53.70
| Facility | | $30.20 | $48.98 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $20.42 / $33.11
| Professional | | $9.33 | $20.42 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $40.74 / $46.77
| Professional | | $37.15 | $40.74 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $74.13
| Facility | | $18.62 | $18.62 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $21.38 / $26.92
| Professional | | $13.49 | $21.38 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $37.15
| Facility | | $18.62 | $18.62 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $22.39
| Professional | | $18.62 | $18.62 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $25.70 / $54.95
| Facility | | $17.78 | $25.70 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $20.42 / $79.43
| Professional | | $16.60 | $20.42 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $54.95 / $75.86
| Facility | | $27.54 | $54.95 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $16.98 / $22.39
| Professional | | $13.80 | $16.98 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $22.39 / $29.51
| Facility | | $8.51 | $22.39 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $22.39
| Professional | | $7.76 | $7.76 | $22.39 |