- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $33.88 / $107.15
| Facility | | $18.20 | $33.88 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $16.98 / $26.92
| Professional | | $12.02 | $16.98 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $26.92 / $36.31
| Facility | | $18.20 | $26.92 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $16.22 / $18.20
| Professional | | $13.80 | $16.22 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $40.74 / $47.86
| Facility | | $16.98 | $40.74 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $19.50 / $26.30
| Professional | | $9.33 | $19.50 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $15.85 / $64.57
| Professional | | $11.75 | $15.85 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $37.15
| Facility | | $18.20 | $18.20 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $18.20 / $18.20
| Professional | | $16.60 | $18.20 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $28.84 / $50.12
| Facility | | $18.20 | $28.84 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $21.88
| Professional | | $16.60 | $16.60 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $27.54 / $47.86
| Facility | | $20.89 | $27.54 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $16.22 / $18.20
| Professional | | $13.80 | $16.22 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $21.88 / $21.88
| Facility | | $16.60 | $21.88 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.76 / $19.95
| Professional | | $7.59 | $7.76 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $9.33 / $33.11
| Professional | | $8.13 | $9.33 | $33.11 |