- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $39.81 / $64.57
| Facility | | $19.95 | $39.81 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.85 / $40.74
| Professional | | $12.88 | $15.85 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $20.89 / $54.95
| Facility | | $20.89 | $20.89 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $10.72 / $45.71
| Professional | | $9.33 | $10.72 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $20.89 / $20.89
| Facility | | $12.59 | $20.89 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $20.89 / $20.89
| Professional | | $15.14 | $20.89 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $50.12 / $204.17
| Facility | | $20.42 | $50.12 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $28.18 / $100.00
| Professional | | $12.59 | $28.18 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $26.92 / $67.61
| Facility | | $16.60 | $26.92 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $14.79 / $40.74
| Professional | | $9.77 | $14.79 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $20.89 / $20.89
| Facility | | $20.89 | $20.89 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $20.89 / $26.92
| Professional | | $17.38 | $20.89 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $39.81 / $50,118.72
| Facility | | $23.44 | $39.81 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $25.12 / $30.90
| Facility | | $14.13 | $25.12 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $14.45 / $47.86
| Professional | | $8.71 | $14.45 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $20.89 / $45.71
| Facility | | $17.78 | $20.89 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $21.88 / $60.26
| Professional | | $17.78 | $21.88 | $60.26 |