- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $44.67 / $125.89
| Facility | | $20.89 | $44.67 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.88 / $22.39
| Professional | | $10.23 | $12.88 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $38.02 / $51.29
| Facility | | $23.44 | $38.02 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $16.22 / $26.92
| Professional | | $10.00 | $16.22 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $31.62 / $37.15
| Professional | | $29.51 | $31.62 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $95.50
| Facility | | $14.45 | $14.45 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $17.78 / $24.55
| Professional | | $13.80 | $17.78 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $28.84
| Facility | | $14.45 | $14.45 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $25.12
| Professional | | $14.45 | $14.45 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $19.95 / $43.65
| Facility | | $13.80 | $19.95 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $17.38 / $79.43
| Professional | | $14.45 | $17.38 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $43.65 / $58.88
| Facility | | $21.38 | $43.65 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $14.79 / $18.20
| Professional | | $10.72 | $14.79 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $17.38 / $22.91
| Facility | | $9.12 | $17.38 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.13 / $19.95
| Professional | | $6.03 | $8.13 | $19.95 |