- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $45.71 / $70.79
| Facility | | $22.39 | $45.71 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $21.88 / $38.02
| Professional | | $18.62 | $21.88 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $17.38
| Professional | | $15.14 | $15.14 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $26.30 / $45.71
| Facility | | $22.91 | $26.30 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $12.88 / $18.20
| Professional | | $9.55 | $12.88 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $16.98
| Facility | | $16.98 | $16.98 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $19.95
| Professional | | $19.95 | $19.95 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $26.30 / $30.90
| Facility | | $16.60 | $26.30 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $25.12 / $33.88
| Professional | | $16.22 | $25.12 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $30.20 / $102.33
| Facility | | $16.22 | $30.20 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $16.98 / $47.86
| Professional | | $12.59 | $16.98 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $28.18 / $102.33
| Facility | | $16.22 | $28.18 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $16.22 / $39.81
| Professional | | $12.59 | $16.22 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $22.39 / $30.90
| Professional | | $18.62 | $22.39 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $30.20
| Facility | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $26.30 / $51.29
| Professional | | $17.38 | $26.30 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $25.12 / $37.15
| Facility | | $12.59 | $25.12 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $15.14 / $30.20
| Professional | | $10.47 | $15.14 | $30.20 |