- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $40.74 / $50.12
| Facility | | $20.89 | $40.74 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.13 / $20.89
| Professional | | $12.02 | $14.13 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $48.98 / $50.12
| Facility | | $38.90 | $48.98 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $66.07
| Professional | | $7.24 | $7.24 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $12.88 / $12.88
| Facility | | $12.88 | $12.88 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $58.88 / $93.33
| Facility | | $50.12 | $58.88 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $25.70 / $57.54
| Professional | | $20.42 | $25.70 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $36.31 / $104.71
| Facility | | $11.75 | $36.31 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $16.60 / $114.82
| Facility | | $11.75 | $16.60 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $10.96 / $33.11
| Professional | | $9.12 | $10.96 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $33.11 / $85.11
| Professional | | $17.78 | $33.11 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $21.88 / $38.02
| Facility | | $20.42 | $21.88 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $25.70 / $51.29
| Professional | | $13.80 | $25.70 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $46.77 / $74.13
| Professional | | $24.55 | $46.77 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $114.82 / $114.82
| Facility | | $36.31 | $114.82 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.91 / $12.88
| Professional | | $8.71 | $8.91 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $38.90
| Professional | | $13.49 | $13.49 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $47.86 / $100.00
| Professional | | $13.49 | $47.86 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $14.45 / $21.88
| Facility | | $9.12 | $14.45 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $10.96 / $33.11
| Professional | | $7.59 | $10.96 | $33.11 |