- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $45.71 / $158.49
| Facility | | $12.02 | $45.71 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.02 / $22.39
| Professional | | $10.00 | $12.02 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $52.48
| Facility | | $30.20 | $30.20 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $9.55 / $10.72
| Professional | | $8.32 | $9.55 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $28.18 / $61.66
| Facility | | $9.55 | $28.18 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $9.33 / $20.42
| Professional | | $7.08 | $9.33 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $29.51 / $89.13
| Professional | | $8.71 | $29.51 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.30 / $22.91
| Facility | | $10.96 | $12.30 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $16.60 / $18.62
| Professional | | $10.96 | $16.60 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $13.80 / $23.99
| Facility | | $6.92 | $13.80 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $8.32 / $19.05
| Professional | | $5.75 | $8.32 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $66.07 / $109.65
| Facility | | $66.07 | $66.07 | $109.65 |