- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $66.07 / $281.84
| Facility | | $16.98 | $66.07 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $17.38 / $54.95
| Professional | | $14.45 | $17.38 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $13.49 / $13.49
| Professional | | $12.88 | $13.49 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $83.18 / $83.18
| Facility | | $42.66 | $83.18 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $17.38 / $20.89
| Professional | | $11.48 | $17.38 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $40.74 / $87.10
| Facility | | $13.49 | $40.74 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $13.49 / $29.51
| Professional | | $10.00 | $13.49 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $33.88 / $41.69
| Professional | | $16.22 | $33.88 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $16.98 / $38.02
| Facility | | $15.49 | $16.98 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $25.70 / $25.70
| Professional | | $15.49 | $25.70 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $19.50 / $33.88
| Facility | | $10.23 | $19.50 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $13.49 / $26.92
| Professional | | $9.77 | $13.49 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |