- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $42.66 / $67.61
| Facility | | $15.14 | $42.66 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $15.85 / $31.62
| Professional | | $14.13 | $15.85 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $22.39 / $128.82
| Facility | | $14.79 | $22.39 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $19.95 / $47.86
| Professional | | $12.02 | $19.95 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $39.81 / $56.23
| Facility | | $31.62 | $39.81 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $20.42
| Professional | | $18.62 | $18.62 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $26.92 / $61.66
| Facility | | $13.80 | $26.92 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $22.91 / $51.29
| Professional | | $11.75 | $22.91 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $134.90 / $7,079.46
| Facility | | $18.20 | $134.90 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $28.18 / $33.11
| Professional | | $28.18 | $28.18 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $47.86
| Professional | | $19.95 | $19.95 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $22.39 / $128.82
| Facility | | $14.79 | $22.39 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $19.95 / $47.86
| Professional | | $12.02 | $19.95 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $19.95 / $23.99
| Facility | | $9.12 | $19.95 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $19.95 / $47.86
| Professional | | $10.72 | $19.95 | $47.86 |