- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $44.67 / $91.20
| Facility | | $15.85 | $44.67 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $13.80 / $19.95
| Professional | | $12.02 | $13.80 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $10.47
| Professional | | $10.23 | $10.23 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $24.55 / $33.88
| Facility | | $16.60 | $24.55 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $15.14 / $16.60
| Professional | | $12.59 | $15.14 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $35.48 / $48.98
| Facility | | $17.38 | $35.48 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $17.78 / $25.70
| Professional | | $9.55 | $17.78 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $14.79 / $64.57
| Professional | | $10.72 | $14.79 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $33.88
| Facility | | $16.60 | $16.60 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $19.95 / $31.62
| Professional | | $16.60 | $19.95 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $26.92 / $45.71
| Facility | | $16.60 | $26.92 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $19.95
| Professional | | $15.14 | $15.14 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $25.12 / $44.67
| Facility | | $19.05 | $25.12 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $15.14 / $16.60
| Professional | | $12.59 | $15.14 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $19.95 / $19.95
| Facility | | $15.14 | $19.95 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.88 / $20.89
| Professional | | $10.00 | $12.88 | $20.89 |