- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $38.90 / $281.84
| Facility | | $21.38 | $38.90 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $15.49 / $25.12
| Professional | | $12.02 | $15.49 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $44.67 / $60.26
| Facility | | $27.54 | $44.67 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $19.05 / $31.62
| Professional | | $11.48 | $19.05 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $37.15 / $43.65
| Professional | | $34.67 | $37.15 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $51.29
| Facility | | $16.98 | $16.98 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $22.91 / $33.88
| Professional | | $16.98 | $22.91 | $33.88 |
- 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 / $20.42
| Professional | | $16.98 | $16.98 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $23.44 / $51.29
| Facility | | $16.22 | $23.44 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $20.42 / $79.43
| Professional | | $16.98 | $20.42 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $51.29 / $69.18
| Facility | | $25.12 | $51.29 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $17.38 / $21.38
| Professional | | $12.59 | $17.38 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $20.42 / $26.92
| Facility | | $10.72 | $20.42 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $9.55 / $23.44
| Professional | | $7.08 | $9.55 | $23.44 |