- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $46.77 / $56.23
| Facility | | $18.62 | $46.77 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $34.67 / $69.18
| Professional | | $19.95 | $34.67 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $37.15 / $46.77
| Professional | | $30.20 | $37.15 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $35.48 / $54.95
| Professional | | $22.91 | $35.48 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $38.90 / $38.90
| Professional | | $38.90 | $38.90 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $25.70 / $37.15
| Facility | | $21.88 | $25.70 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $38.90 / $75.86
| Professional | | $34.67 | $38.90 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $30.20 / $36.31
| Facility | | $20.42 | $30.20 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $38.02 / $69.18
| Professional | | $23.44 | $38.02 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $36.31
| Facility | | $36.31 | $36.31 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $38.90 / $64.57
| Professional | | $23.44 | $38.90 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $30.90 / $45.71
| Professional | | $20.42 | $30.90 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $38.90 / $60.26
| Professional | | $21.38 | $38.90 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $41.69 / $51.29
| Facility | | $35.48 | $41.69 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $34.67 / $60.26
| Professional | | $21.88 | $34.67 | $60.26 |