- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $35.48 / $120.23
| Facility | | $14.45 | $35.48 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $11.75 / $16.98
| Professional | | $10.96 | $11.75 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $38.02 / $45.71
| Facility | | $23.44 | $38.02 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $16.22 / $25.70
| Professional | | $8.71 | $16.22 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $32.36 / $37.15
| Professional | | $29.51 | $32.36 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $63.10
| Facility | | $14.45 | $14.45 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $17.38 / $25.70
| Professional | | $14.13 | $17.38 | $25.70 |
- 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 / $17.38
| Professional | | $14.45 | $14.45 | $17.38 |
- 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
- $21.88 / $43.65 / $60.26
| Facility | | $21.88 | $43.65 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.18 / $17.38
| Professional | | $10.96 | $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 / $17.78
| Professional | | $6.03 | $7.41 | $17.78 |