- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $35.48 / $43.65
| Facility | | $19.05 | $35.48 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.02 / $22.39
| Professional | | $10.00 | $12.02 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $42.66 / $43.65
| Facility | | $34.67 | $42.66 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $60.26
| Professional | | $6.46 | $6.46 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $12.02
| Facility | | $12.02 | $12.02 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $51.29 / $83.18
| Facility | | $43.65 | $51.29 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $22.91 / $50.12
| Professional | | $18.20 | $22.91 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $32.36 / $95.50
| Facility | | $7.94 | $32.36 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $14.45 / $123.03
| Facility | | $7.94 | $14.45 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $10.00 / $30.90
| Professional | | $8.71 | $10.00 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $32.36 / $64.57
| Professional | | $15.85 | $32.36 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $19.05 / $34.67
| Facility | | $18.62 | $19.05 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $22.91 / $45.71
| Professional | | $12.02 | $22.91 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $38.02 / $53.70
| Professional | | $21.38 | $38.02 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $123.03 / $123.03
| Facility | | $32.36 | $123.03 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.94 / $11.75
| Professional | | $7.76 | $7.94 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $33.88
| Professional | | $18.62 | $18.62 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $46.77 / $87.10
| Professional | | $18.62 | $46.77 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $12.88 / $19.05
| Facility | | $7.94 | $12.88 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.23 / $29.51
| Professional | | $7.08 | $10.23 | $29.51 |