- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $30.20 / $37.15
| Facility | | $15.85 | $30.20 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.96 / $15.85
| Professional | | $10.00 | $10.96 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $36.31 / $37.15
| Facility | | $29.51 | $36.31 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $54.95
| Professional | | $5.62 | $5.62 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $10.72
| Facility | | $10.72 | $10.72 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $44.67 / $70.79
| Facility | | $38.02 | $44.67 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $19.50 / $42.66
| Professional | | $15.85 | $19.50 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $26.92 / $91.20
| Facility | | $10.23 | $26.92 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.30 / $100.00
| Facility | | $10.23 | $12.30 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $9.33 / $25.70
| Professional | | $6.76 | $9.33 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $33.11 / $85.11
| Professional | | $6.76 | $33.11 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $32.36
| Facility | | $16.22 | $16.22 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $21.88 / $38.90
| Professional | | $10.23 | $21.88 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $34.67 / $83.18
| Professional | | $18.20 | $34.67 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $100.00
| Facility | | $50.12 | $50.12 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.59 / $11.22
| Professional | | $7.24 | $7.59 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $28.84
| Professional | | $11.75 | $11.75 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $39.81 / $75.86
| Professional | | $11.75 | $39.81 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $10.96 / $16.22
| Facility | | $6.76 | $10.96 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $9.55 / $26.30
| Professional | | $5.75 | $9.55 | $26.30 |