- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $23.99 / $70.79
| Facility | | $19.50 | $23.99 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $14.13 / $23.99
| Professional | | $9.77 | $14.13 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $40.74 / $45.71
| Facility | | $25.12 | $40.74 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $17.78 / $28.18
| Professional | | $8.32 | $17.78 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.88 / $39.81
| Professional | | $32.36 | $33.88 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $22.39
| Facility | | $15.49 | $15.49 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $17.78 / $23.99
| Professional | | $15.49 | $17.78 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $31.62
| Facility | | $15.49 | $15.49 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $17.78
| Professional | | $15.49 | $15.49 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $21.88 / $45.71
| Facility | | $14.13 | $21.88 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $16.98 / $79.43
| Professional | | $14.13 | $16.98 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $46.77 / $64.57
| Facility | | $23.44 | $46.77 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $14.13 / $18.62
| Professional | | $11.75 | $14.13 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $18.62 / $25.12
| Facility | | $7.59 | $18.62 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $6.92 / $18.62
| Professional | | $6.61 | $6.92 | $18.62 |