- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $26.92 / $79.43
| Facility | | $21.88 | $26.92 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $15.85 / $26.92
| Professional | | $7.94 | $15.85 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $34.67 / $51.29
| Facility | | $28.18 | $34.67 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $19.05 / $30.90
| Professional | | $6.61 | $19.05 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $38.02 / $44.67
| Professional | | $35.48 | $38.02 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $17.38 / $24.55
| Facility | | $16.98 | $17.38 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $17.38 / $25.12
| Professional | | $8.91 | $17.38 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $35.48
| Facility | | $17.38 | $17.38 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $26.30
| Professional | | $17.38 | $17.38 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $24.55 / $51.29
| Facility | | $9.77 | $24.55 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $19.05 / $79.43
| Professional | | $8.71 | $19.05 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $51.29 / $69.18
| Facility | | $26.30 | $51.29 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $13.18 / $20.89
| Professional | | $6.61 | $13.18 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $20.89 / $28.18
| Facility | | $6.03 | $20.89 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $7.41 / $20.89
| Professional | | $5.50 | $7.41 | $20.89 |