- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $28.18 / $81.28
| Facility | | $25.70 | $28.18 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $28.18 / $64.57
| Professional | | $20.89 | $28.18 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $26.92 / $60.26 / $97.72
| Professional | 25 | $26.92 | $60.26 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $53.70 / $295.12
| Facility | | $21.88 | $53.70 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $35.48 / $77.62
| Professional | | $24.55 | $35.48 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $35.48 / $64.57
| Facility | | $25.12 | $35.48 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $46.77 / $61.66
| Professional | | $28.18 | $46.77 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $34.67 / $63.10
| Professional | | $22.39 | $34.67 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $22.91 / $45.71
| Facility | | $12.02 | $22.91 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $27.54 / $47.86
| Professional | | $15.49 | $27.54 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $44.67 / $72.44
| Professional | | $26.30 | $44.67 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $42.66 / $56.23
| Professional | | $33.88 | $42.66 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $53.70 / $295.12
| Facility | | $21.88 | $53.70 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $35.48 / $77.62
| Professional | | $24.55 | $35.48 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $52.48 / $54.95
| Facility | | $21.38 | $52.48 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $36.31 / $75.86
| Professional | | $23.44 | $36.31 | $75.86 |