- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $67.61 / $239.88
| Facility | | $17.78 | $67.61 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $16.98 / $32.36
| Professional | | $14.13 | $16.98 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.02 / $13.49
| Professional | | $10.96 | $12.02 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $22.39 / $26.30
| Facility | | $19.50 | $22.39 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $22.39 / $24.55
| Professional | | $17.78 | $22.39 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $21.38 / $57.54
| Facility | | $14.45 | $21.38 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $17.78 / $39.81
| Professional | | $10.96 | $17.78 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $72.44 / $158.49
| Facility | | $17.38 | $72.44 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $24.55
| Professional | | $13.18 | $13.18 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $10.72 / $13.18
| Professional | | $2.63 | $10.72 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $14.79 / $22.39
| Facility | | $9.33 | $14.79 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.72 / $25.12
| Professional | | $8.32 | $10.72 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $22.39
| Professional | | $13.18 | $13.18 | $22.39 |