- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $57.54 / $147.91
| Facility | | $22.91 | $57.54 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $15.14 / $42.66
| Professional | | $12.30 | $15.14 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.00 / $11.75
| Professional | | $7.08 | $10.00 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $25.12 / $33.88
| Facility | | $17.78 | $25.12 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $15.14 / $16.98
| Professional | | $12.59 | $15.14 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $37.15 / $53.70
| Facility | | $17.38 | $37.15 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $17.78 / $26.30
| Professional | | $10.47 | $17.78 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $14.79 / $17.78
| Professional | | $10.72 | $14.79 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $33.88
| Facility | | $16.98 | $16.98 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $22.91
| Professional | | $16.98 | $16.98 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $29.51 / $45.71
| Facility | | $16.98 | $29.51 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $19.95
| Professional | | $15.14 | $15.14 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $25.12 / $44.67
| Facility | | $19.50 | $25.12 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $15.14 / $16.98
| Professional | | $12.59 | $15.14 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $19.95 / $19.95
| Facility | | $15.14 | $19.95 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $9.77 / $23.44
| Professional | | $7.08 | $9.77 | $23.44 |