- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $43.65 / $81.28
| Facility | | $18.20 | $43.65 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $16.98 / $38.02
| Professional | | $14.13 | $16.98 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $26.92 / $91.20
| Facility | | $17.38 | $26.92 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $19.05 / $54.95
| Professional | | $11.22 | $19.05 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $46.77 / $67.61
| Facility | | $37.15 | $46.77 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $23.99
| Professional | | $17.78 | $17.78 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $30.20 / $72.44
| Facility | | $12.30 | $30.20 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $21.38 / $50.12
| Professional | | $11.48 | $21.38 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $75.86 / $7,079.46
| Facility | | $13.80 | $75.86 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $26.92 / $31.62
| Professional | | $26.92 | $26.92 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $57.54
| Professional | | $19.05 | $19.05 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $26.92 / $91.20
| Facility | | $17.38 | $26.92 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $19.05 / $54.95
| Professional | | $11.22 | $19.05 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $19.05 / $27.54
| Facility | | $9.55 | $19.05 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $19.05 / $60.26
| Professional | | $11.22 | $19.05 | $60.26 |