- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $26.30 / $77.62
| Facility | | $21.38 | $26.30 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $15.85 / $26.30
| Professional | | $10.96 | $15.85 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $44.67 / $57.54
| Facility | | $27.54 | $44.67 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $19.05 / $30.90
| Professional | | $11.22 | $19.05 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $38.02 / $43.65
| Professional | | $34.67 | $38.02 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $24.55
| Facility | | $16.98 | $16.98 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $21.88 / $32.36
| Professional | | $16.98 | $21.88 | $32.36 |
- 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 / $32.36
| Professional | | $16.98 | $16.98 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $23.99 / $50.12
| Facility | | $15.85 | $23.99 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $20.42 / $79.43
| Professional | | $16.22 | $20.42 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $51.29 / $70.79
| Facility | | $25.70 | $51.29 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $16.60 / $20.42
| Professional | | $12.88 | $16.60 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $20.42 / $27.54
| Facility | | $10.00 | $20.42 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $9.12 / $22.39
| Professional | | $7.24 | $9.12 | $22.39 |