- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $48.98 / $190.55
| Facility | | $15.85 | $48.98 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $14.45 / $79.43
| Professional | | $7.94 | $14.45 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $32.36 / $43.65
| Facility | | $19.95 | $32.36 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $13.80 / $22.39
| Professional | | $8.32 | $13.80 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $26.92 / $31.62
| Professional | | $25.12 | $26.92 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $125.89
| Facility | | $12.30 | $12.30 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $16.60 / $23.99
| Professional | | $12.30 | $16.60 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $24.55
| Facility | | $12.30 | $12.30 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $17.38
| Professional | | $12.30 | $12.30 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $17.78 / $36.31
| Facility | | $11.75 | $17.78 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.79 / $79.43
| Professional | | $12.02 | $14.79 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $37.15 / $51.29
| Facility | | $18.62 | $37.15 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $12.30 / $15.49
| Professional | | $9.33 | $12.30 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $14.79 / $19.50
| Facility | | $7.59 | $14.79 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.77 / $16.98
| Professional | | $7.41 | $9.77 | $16.98 |