- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $44.67 / $81.28
| Facility | | $18.20 | $44.67 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $18.20 / $38.02
| Professional | | $14.13 | $18.20 | $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
- $11.48 / $19.50 / $56.23
| Professional | | $11.48 | $19.50 | $56.23 |
- 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
- $18.20 / $18.20 / $23.99
| Professional | | $18.20 | $18.20 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $30.20 / $72.44
| Facility | | $9.77 | $30.20 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $22.39 / $50.12
| Professional | | $11.75 | $22.39 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $38.02 / $7,079.46
| Facility | | $6.92 | $38.02 | $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
- $19.50 / $19.50 / $57.54
| Professional | | $19.50 | $19.50 | $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
- $11.48 / $19.50 / $56.23
| Professional | | $11.48 | $19.50 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $19.50 / $27.54
| Facility | | $9.55 | $19.50 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $19.50 / $60.26
| Professional | | $9.55 | $19.50 | $60.26 |