- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $17.78 / $28.84
| Facility | | $16.60 | $17.78 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.88 / $25.12
| Professional | | $10.00 | $12.88 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $28.84 / $42.66
| Facility | | $21.38 | $28.84 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $27.54 / $30.20
| Professional | | $15.49 | $27.54 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $75.86 / $100.00
| Facility | | $70.79 | $75.86 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $14.13 / $25.12
| Professional | | $10.96 | $14.13 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $17.38 / $30.90
| Facility | | $12.30 | $17.38 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $17.78 / $29.51
| Professional | | $12.02 | $17.78 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $21.38 / $32.36
| Facility | | $21.38 | $21.38 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $15.49 / $17.38
| Professional | | $13.18 | $15.49 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $14.13 / $35.48
| Professional | | $13.80 | $14.13 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $16.60
| Facility | | $16.60 | $16.60 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $15.14 / $19.50
| Professional | | $13.49 | $15.14 | $19.50 |