- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $38.90 / $89.13
| Facility | | $17.78 | $38.90 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $18.20 / $42.66
| Professional | | $15.14 | $18.20 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $12.30
| Professional | | $12.30 | $12.30 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $21.88 / $38.02
| Facility | | $19.05 | $21.88 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.88 / $26.92
| Professional | | $10.23 | $12.88 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $21.88 / $25.70
| Facility | | $14.13 | $21.88 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $20.89 / $28.18
| Professional | | $13.49 | $20.89 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $26.92 / $85.11
| Facility | | $13.49 | $26.92 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $13.49 / $39.81
| Professional | | $10.47 | $13.49 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $22.91 / $141.25
| Facility | | $13.49 | $22.91 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $15.49 / $28.84
| Professional | | $11.22 | $15.49 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $18.62 / $25.70
| Professional | | $15.49 | $18.62 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $24.55 / $24.55
| Facility | | $24.55 | $24.55 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $21.88 / $42.66
| Professional | | $14.45 | $21.88 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $20.89 / $30.90
| Facility | | $8.71 | $20.89 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $12.30 / $27.54
| Professional | | $8.71 | $12.30 | $27.54 |