- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $39.81 / $39.81
| Facility | | $39.81 | $39.81 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $16.98 / $28.84
| Professional | | $9.12 | $16.98 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.50 / $13.18
| Professional | | $5.01 | $5.50 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $23.99 / $79.43
| Facility | | $23.99 | $23.99 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $15.14 / $37.15
| Professional | | $7.24 | $15.14 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $114.82 / $114.82
| Facility | | $114.82 | $114.82 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $181.97 / $181.97
| Professional | | $120.23 | $181.97 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $23.99 / $36.31
| Facility | | $16.98 | $23.99 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $21.88 / $36.31
| Professional | | $14.13 | $21.88 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $23.99
| Professional | | $20.42 | $20.42 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $25.70 / $51.29
| Professional | | $23.44 | $25.70 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $21.88 / $38.02
| Facility | | $16.22 | $21.88 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $16.98 / $37.15
| Professional | | $7.24 | $16.98 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $11.48
| Facility | | $11.48 | $11.48 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $15.14 / $47.86
| Professional | | $8.71 | $15.14 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $12.59 / $23.99
| Professional | | $9.33 | $12.59 | $23.99 |