- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $46.77 / $74.13
| Facility | | $18.62 | $46.77 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $12.02 / $22.91
| Professional | | $9.55 | $12.02 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $38.02 / $46.77
| Facility | | $23.44 | $38.02 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $16.22 / $25.70
| Professional | | $8.91 | $16.22 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $31.62 / $37.15
| Professional | | $29.51 | $31.62 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $54.95
| Facility | | $14.45 | $14.45 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $17.78 / $21.88
| Professional | | $14.45 | $17.78 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $28.84
| Facility | | $14.45 | $14.45 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $16.60
| Professional | | $14.45 | $14.45 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $19.95 / $42.66
| Facility | | $12.88 | $19.95 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $16.60 / $79.43
| Professional | | $12.88 | $16.60 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $42.66 / $58.88
| Facility | | $21.38 | $42.66 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $13.18 / $17.38
| Professional | | $10.72 | $13.18 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $17.38 / $22.91
| Facility | | $8.13 | $17.38 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.41 / $18.20
| Professional | | $6.03 | $7.41 | $18.20 |