- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $30.20 / $87.10
| Facility | | $15.14 | $30.20 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $14.13 / $22.39
| Professional | | $10.00 | $14.13 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $22.39 / $30.20
| Facility | | $15.14 | $22.39 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $13.49 / $15.14
| Professional | | $11.22 | $13.49 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $33.11 / $43.65
| Facility | | $15.49 | $33.11 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $15.85 / $22.91
| Professional | | $8.13 | $15.85 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $32.36 / $64.57
| Professional | | $11.48 | $32.36 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $30.20
| Facility | | $15.14 | $15.14 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $26.30 / $41.69
| Facility | | $15.14 | $26.30 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $18.20
| Professional | | $13.49 | $13.49 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $22.39 / $39.81
| Facility | | $17.38 | $22.39 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $13.49 / $15.14
| Professional | | $11.22 | $13.49 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $18.20 / $18.20
| Facility | | $13.49 | $18.20 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $7.76 / $18.20
| Professional | | $6.31 | $7.76 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $7.76 / $26.92
| Professional | | $6.76 | $7.76 | $26.92 |