- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $36.31 / $60.26
| Facility | | $16.60 | $36.31 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $18.20 / $30.90
| Professional | | $15.14 | $18.20 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $21.38 / $37.15
| Facility | | $18.62 | $21.38 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.59 / $25.70
| Professional | | $10.00 | $12.59 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $23.44
| Facility | | $15.49 | $15.49 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $27.54 / $27.54
| Professional | | $27.54 | $27.54 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $26.30 / $85.11
| Facility | | $13.18 | $26.30 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $13.18 / $38.02
| Professional | | $10.23 | $13.18 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.49 / $85.11
| Facility | | $13.18 | $13.49 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $13.18 / $33.88
| Professional | | $10.23 | $13.18 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $18.20 / $25.12
| Professional | | $15.14 | $18.20 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $23.99 / $23.99
| Facility | | $23.99 | $23.99 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $21.38 / $41.69
| Professional | | $14.13 | $21.38 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $20.42 / $30.20
| Facility | | $10.00 | $20.42 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $12.02 / $23.99
| Professional | | $8.51 | $12.02 | $23.99 |