- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $39.81 / $104.71
| Facility | | $10.96 | $39.81 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- 25
- Typical Low / Median / Typical High
- $9.55 / $9.55 / $9.55
| Facility | 25 | $9.55 | $9.55 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $16.60 / $31.62
| Professional | | $10.47 | $16.60 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $18.20 / $27.54 / $50.12
| Professional | 25 | $18.20 | $27.54 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $13.49 / $19.05
| Professional | | $10.47 | $13.49 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $10.72 / $14.45 / $19.50
| Professional | 25 | $10.72 | $14.45 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $13.18 / $21.38
| Professional | | $10.47 | $13.18 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $16.98 / $20.89
| Professional | | $12.30 | $16.98 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.59 / $18.20
| Facility | | $10.96 | $12.59 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $14.79 / $28.84
| Professional | | $13.49 | $14.79 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $14.79 / $18.20
| Facility | | $10.23 | $14.79 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $15.49 / $27.54
| Professional | | $11.22 | $15.49 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $18.20
| Facility | | $18.20 | $18.20 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $15.49 / $25.70
| Professional | | $11.22 | $15.49 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $32.36 / $33.11
| Professional | | $8.51 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $15.49 / $24.55
| Professional | | $10.96 | $15.49 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $18.20 / $128.82
| Facility | | $10.23 | $18.20 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $14.13 / $23.99
| Professional | | $10.00 | $14.13 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $79.43 / $95.50 / $95.50
| Professional | 25 | $79.43 | $95.50 | $95.50 |