- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $50.12 / $87.10
| Facility | | $19.05 | $50.12 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $11.75 / $21.38
| Professional | | $9.77 | $11.75 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $34.67 / $47.86
| Facility | | $21.38 | $34.67 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $14.79 / $25.12
| Professional | | $9.12 | $14.79 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $29.51 / $33.11
| Professional | | $26.92 | $29.51 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $14.13 / $79.43
| Facility | | $13.18 | $14.13 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $16.60 / $22.91
| Professional | | $11.75 | $16.60 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $26.92
| Facility | | $13.18 | $13.18 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $16.60
| Professional | | $13.18 | $13.18 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $19.05 / $39.81
| Facility | | $12.88 | $19.05 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $15.85 / $79.43
| Professional | | $13.18 | $15.85 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $39.81 / $54.95
| Facility | | $19.95 | $39.81 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $13.49 / $16.98
| Professional | | $10.00 | $13.49 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $15.85 / $20.89
| Facility | | $8.32 | $15.85 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $7.59 / $18.62
| Professional | | $5.50 | $7.59 | $18.62 |