- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $66.07 / $162.18
| Facility | | $17.78 | $66.07 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.14 / $26.30
| Professional | | $12.88 | $15.14 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $11.75 / $11.75
| Professional | | $10.72 | $11.75 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $26.30 / $35.48
| Facility | | $18.62 | $26.30 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $16.22 / $17.78
| Professional | | $13.49 | $16.22 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $38.02 / $53.70
| Facility | | $18.62 | $38.02 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $19.05 / $27.54
| Professional | | $10.47 | $19.05 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $15.85 / $64.57
| Professional | | $11.48 | $15.85 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $36.31
| Facility | | $17.78 | $17.78 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $17.78
| Professional | | $17.78 | $17.78 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $31.62 / $48.98
| Facility | | $17.78 | $31.62 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $21.38
| Professional | | $16.22 | $16.22 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $26.92 / $47.86
| Facility | | $20.42 | $26.92 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $16.22 / $17.78
| Professional | | $13.49 | $16.22 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $21.38 / $21.38
| Facility | | $16.22 | $21.38 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $10.00 / $23.44
| Professional | | $7.59 | $10.00 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $9.33 / $32.36
| Professional | | $8.13 | $9.33 | $32.36 |