- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $30.20 / $93.33
| Facility | | $15.85 | $30.20 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.14 / $23.44
| Professional | | $10.00 | $15.14 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $23.44 / $32.36
| Facility | | $15.85 | $23.44 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.45 / $15.85
| Professional | | $12.02 | $14.45 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $35.48 / $42.66
| Facility | | $15.49 | $35.48 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $16.98 / $22.91
| Professional | | $7.94 | $16.98 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $14.13 / $64.57
| Professional | | $10.23 | $14.13 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $15.85 / $32.36
| Facility | | $15.85 | $15.85 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $15.85 / $17.78
| Professional | | $15.85 | $15.85 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $25.70 / $43.65
| Facility | | $15.85 | $25.70 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $19.05
| Professional | | $14.45 | $14.45 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $23.99 / $42.66
| Facility | | $18.20 | $23.99 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.45 / $15.85
| Professional | | $12.02 | $14.45 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $19.05 / $19.05
| Facility | | $14.45 | $19.05 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $7.08 / $17.78
| Professional | | $6.76 | $7.08 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $8.32 / $28.84
| Professional | | $7.24 | $8.32 | $28.84 |