- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $36.31 / $154.88
| Facility | | $18.20 | $36.31 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $13.18 / $21.88
| Professional | | $8.91 | $13.18 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $38.90 / $52.48
| Facility | | $23.99 | $38.90 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $16.60 / $27.54
| Professional | | $10.00 | $16.60 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $32.36 / $38.02
| Professional | | $30.20 | $32.36 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $14.79 / $48.98
| Facility | | $14.79 | $14.79 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $19.95 / $29.51
| Professional | | $14.79 | $19.95 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $14.79 / $29.51
| Facility | | $14.79 | $14.79 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $14.79 / $21.88
| Professional | | $14.79 | $14.79 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $20.42 / $44.67
| Facility | | $14.13 | $20.42 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $17.78 / $79.43
| Professional | | $14.79 | $17.78 | $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 / $15.14 / $18.62
| Professional | | $10.96 | $15.14 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $17.78 / $23.44
| Facility | | $9.33 | $17.78 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $8.32 / $20.42
| Professional | | $6.17 | $8.32 | $20.42 |