- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $38.02 / $66.07
| Facility | | $23.44 | $38.02 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $37.15 / $64.57
| Professional | | $19.50 | $37.15 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $23.99 / $29.51
| Professional | | $18.62 | $23.99 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $28.18 / $46.77
| Professional | | $20.89 | $28.18 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $37.15 / $37.15
| Professional | | $37.15 | $37.15 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $22.39 / $27.54
| Facility | | $19.95 | $22.39 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $23.44 / $46.77
| Professional | | $19.50 | $23.44 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $33.88
| Facility | | $33.88 | $33.88 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $28.84 / $52.48
| Professional | | $20.42 | $28.84 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $33.88
| Facility | | $33.88 | $33.88 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $28.84 / $53.70
| Professional | | $19.05 | $28.84 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $32.36 / $33.11
| Professional | | $20.89 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $26.30 / $39.81
| Professional | | $21.38 | $26.30 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $26.92 / $45.71
| Professional | | $18.62 | $26.92 | $45.71 |