- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $45.71 / $91.20
| Facility | | $11.75 | $45.71 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.88 / $28.18
| Professional | | $10.96 | $12.88 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $10.00 / $22.39
| Professional | | $9.55 | $10.00 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $61.66 / $61.66
| Facility | | $32.36 | $61.66 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $10.00 / $13.18
| Professional | | $8.71 | $10.00 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $29.51 / $66.07
| Facility | | $10.00 | $29.51 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.77 / $21.88
| Professional | | $7.41 | $9.77 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.02 / $24.55
| Professional | | $10.96 | $12.02 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $12.59 / $28.18
| Facility | | $11.48 | $12.59 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $16.22 / $17.78
| Professional | | $11.48 | $16.22 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $87.10 / $186.21
| Facility | | $87.10 | $87.10 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $14.45 / $25.12
| Facility | | $7.24 | $14.45 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $10.00 / $19.95
| Professional | | $6.03 | $10.00 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $69.18 / $69.18
| Facility | | $69.18 | $69.18 | $69.18 |