- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $33.88 / $97.72
| Facility | | $27.54 | $33.88 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $19.95 / $41.69
| Professional | | $14.13 | $19.95 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $57.54 / $72.44
| Facility | | $35.48 | $57.54 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $23.99 / $39.81
| Professional | | $13.80 | $23.99 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $47.86 / $57.54
| Professional | | $23.99 | $47.86 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $21.88 / $48.98
| Facility | | $21.38 | $21.88 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $27.54 / $36.31
| Professional | | $21.88 | $27.54 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $21.88 / $44.67
| Facility | | $21.88 | $21.88 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $21.88 / $26.30
| Professional | | $21.88 | $21.88 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $32.36 / $64.57
| Facility | | $21.38 | $32.36 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $28.18 / $79.43
| Professional | | $19.95 | $28.18 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $66.07 / $91.20
| Facility | | $33.11 | $66.07 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $18.62 / $26.30
| Professional | | $16.98 | $18.62 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $33.11 / $34.67
| Facility | | $26.30 | $33.11 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $11.48 / $26.30
| Professional | | $9.12 | $11.48 | $26.30 |