- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $44.67 / $117.49
| Facility | | $20.42 | $44.67 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $18.20 / $30.20
| Professional | | $13.18 | $18.20 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $30.20 / $40.74
| Facility | | $21.38 | $30.20 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $18.20 / $20.42
| Professional | | $15.14 | $18.20 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $44.67 / $72.44
| Facility | | $20.89 | $44.67 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $21.38 / $31.62
| Professional | | $12.59 | $21.38 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $17.78 / $64.57
| Professional | | $12.88 | $17.78 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $40.74
| Facility | | $20.42 | $20.42 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $20.42
| Professional | | $20.42 | $20.42 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $35.48 / $54.95
| Facility | | $20.42 | $35.48 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $23.99
| Professional | | $18.20 | $18.20 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $30.20 / $53.70
| Facility | | $23.44 | $30.20 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $18.20 / $20.42
| Professional | | $15.14 | $18.20 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $23.99 / $23.99
| Facility | | $18.20 | $23.99 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $11.75 / $25.70
| Professional | | $8.51 | $11.75 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $10.47 / $36.31
| Professional | | $9.12 | $10.47 | $36.31 |