- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $27.54 / $47.86
| Facility | | $12.88 | $27.54 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.88 / $24.55
| Professional | | $10.00 | $12.88 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $16.98 / $29.51
| Facility | | $14.79 | $16.98 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $8.32 / $18.62
| Professional | | $6.46 | $8.32 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $18.62
| Facility | | $12.02 | $12.02 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $21.88 / $21.88
| Professional | | $21.88 | $21.88 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $19.50 / $66.07
| Facility | | $10.47 | $19.50 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $8.71 / $23.99
| Professional | | $7.41 | $8.71 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $10.72 / $54.95
| Facility | | $10.47 | $10.72 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $8.32 / $16.60
| Professional | | $7.41 | $8.32 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.45 / $19.95
| Professional | | $12.02 | $14.45 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $19.50 / $19.50
| Facility | | $19.50 | $19.50 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $16.98 / $33.11
| Professional | | $11.22 | $16.98 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $16.22 / $23.99
| Facility | | $7.94 | $16.22 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $9.55 / $16.60
| Professional | | $6.76 | $9.55 | $16.60 |