- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $36.31 / $154.88
| Facility | | $12.88 | $36.31 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.88 / $19.95
| Professional | | $10.00 | $12.88 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $10.23 / $11.75
| Professional | | $8.13 | $10.23 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $48.98 / $89.13
| Facility | | $17.78 | $48.98 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $9.33 / $16.98
| Professional | | $5.01 | $9.33 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $16.98
| Facility | | $16.60 | $16.60 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $35.48 / $85.11
| Facility | | $19.05 | $35.48 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $12.30 / $28.18
| Professional | | $9.55 | $12.30 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $79.43
| Facility | | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $33.88
| Professional | | $33.88 | $33.88 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $16.98 / $79.43
| Facility | | $12.88 | $16.98 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.14 / $25.12
| Professional | | $10.00 | $15.14 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $14.13 / $14.13
| Professional | | $12.59 | $14.13 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $16.98 / $51.29
| Facility | | $13.49 | $16.98 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $12.02 / $28.18
| Professional | | $9.55 | $12.02 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $16.98 / $20.42
| Facility | | $7.08 | $16.98 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $9.55 / $14.45
| Professional | | $7.08 | $9.55 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $8.71 / $11.75
| Professional | | $6.61 | $8.71 | $11.75 |