- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $69.18 / $323.59
| Facility | | $16.60 | $69.18 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $12.59 / $45.71
| Professional | | $11.48 | $12.59 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $10.47 / $10.72
| Professional | | $10.47 | $10.47 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $25.70 / $34.67
| Facility | | $17.38 | $25.70 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.49 / $17.38
| Professional | | $12.88 | $15.49 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $38.02 / $50.12
| Facility | | $16.60 | $38.02 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $18.20 / $24.55
| Professional | | $8.71 | $18.20 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $15.14 / $64.57
| Professional | | $10.96 | $15.14 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $34.67
| Facility | | $17.38 | $17.38 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $34.67
| Professional | | $17.38 | $17.38 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $27.54 / $47.86
| Facility | | $17.38 | $27.54 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $20.89
| Professional | | $15.49 | $15.49 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $25.70 / $45.71
| Facility | | $19.95 | $25.70 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.49 / $17.38
| Professional | | $12.88 | $15.49 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $20.89 / $20.89
| Facility | | $15.49 | $20.89 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.59 / $19.50
| Professional | | $7.24 | $7.59 | $19.50 |