- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $30.20 / $89.13
| Facility | | $24.55 | $30.20 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $19.05 / $30.20
| Professional | | $12.59 | $19.05 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $52.48 / $57.54
| Facility | | $32.36 | $52.48 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $22.39 / $35.48
| Professional | | $10.96 | $22.39 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $43.65 / $50.12
| Professional | | $40.74 | $43.65 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $28.84
| Facility | | $19.95 | $19.95 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $22.91 / $32.36
| Professional | | $19.95 | $22.91 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $39.81
| Facility | | $19.95 | $19.95 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $37.15
| Professional | | $19.95 | $19.95 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $27.54 / $58.88
| Facility | | $17.78 | $27.54 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $21.88 / $79.43
| Professional | | $17.78 | $21.88 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $58.88 / $81.28
| Facility | | $29.51 | $58.88 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $18.20 / $23.99
| Professional | | $14.79 | $18.20 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $23.99 / $31.62
| Facility | | $10.00 | $23.99 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $9.12 / $23.99
| Professional | | $8.32 | $9.12 | $23.99 |