- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $25.70 / $32.36
| Facility | | $22.91 | $25.70 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $47.86 / $245.47
| Professional | | $23.99 | $47.86 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $38.90 / $74.13
| Professional | | $28.18 | $38.90 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $28.84 / $51.29
| Professional | | $25.70 | $28.84 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $45.71 / $45.71
| Facility | | $45.71 | $45.71 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $39.81 / $61.66
| Professional | | $29.51 | $39.81 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $35.48 / $47.86
| Professional | | $25.70 | $35.48 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $33.88 / $54.95
| Facility | | $26.92 | $33.88 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $27.54 / $27.54
| Professional | | $27.54 | $27.54 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $38.02 / $57.54
| Facility | | $28.18 | $38.02 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $39.81 / $60.26
| Professional | | $29.51 | $39.81 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $30.20 / $46.77
| Facility | | $23.99 | $30.20 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $37.15 / $60.26
| Professional | | $26.30 | $37.15 | $60.26 |