- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $22.39 / $41.69
| Facility | | $22.39 | $22.39 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $21.88 / $52.48
| Professional | | $14.13 | $21.88 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $61.66
| Professional | | $10.96 | $10.96 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $17.38 / $19.50
| Facility | | $7.41 | $17.38 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $19.05 / $37.15
| Professional | | $10.00 | $19.05 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $34.67 / $44.67
| Facility | | $28.18 | $34.67 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $30.90 / $89.13
| Professional | | $12.59 | $30.90 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $21.88 / $21.88
| Facility | | $21.88 | $21.88 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $26.92 / $42.66
| Professional | | $20.89 | $26.92 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $26.92 / $48.98
| Professional | | $23.44 | $26.92 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $28.84 / $34.67
| Professional | | $26.30 | $28.84 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $18.62 / $33.11
| Facility | | $14.45 | $18.62 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $26.92 / $57.54
| Professional | | $14.13 | $26.92 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $26.92 / $66.07
| Professional | | $20.42 | $26.92 | $66.07 |