- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $41.69 / $50.12
| Facility | | $19.95 | $41.69 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $15.14 / $33.88
| Professional | | $10.96 | $15.14 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $44.67
| Professional | | $8.91 | $8.91 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $17.78 / $17.78
| Facility | | $10.72 | $17.78 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $17.78 / $17.78
| Professional | | $13.18 | $17.78 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $38.90 / $46.77
| Facility | | $28.84 | $38.90 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $24.55 / $74.13
| Professional | | $12.30 | $24.55 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.51 / $8.51
| Facility | | $8.51 | $8.51 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $15.14 / $26.30
| Professional | | $12.59 | $15.14 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $17.78 / $32.36
| Professional | | $16.98 | $17.78 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $21.38
| Professional | | $17.78 | $17.78 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $17.78
| Facility | | $17.78 | $17.78 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $17.38 / $34.67
| Professional | | $8.13 | $17.38 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $17.78 / $42.66
| Professional | | $15.14 | $17.78 | $42.66 |