- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $26.92 / $35.48
| Facility | | $22.39 | $26.92 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.14 / $40.74
| Professional | | $10.00 | $15.14 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $21.38 / $21.38 / $21.38
| Professional | 25 | $21.38 | $21.38 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $25.12 / $32.36
| Professional | | $16.60 | $25.12 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $23.99 / $35.48
| Professional | | $17.38 | $23.99 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $19.50 / $19.50
| Facility | | $19.50 | $19.50 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $23.44 / $44.67
| Professional | | $14.45 | $23.44 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $18.62 / $31.62
| Facility | | $12.02 | $18.62 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $18.20 / $30.90
| Professional | | $11.75 | $18.20 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $32.36 / $33.11
| Professional | | $9.55 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $29.51 / $29.51
| Facility | | $24.55 | $29.51 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $19.95
| Facility | | $19.95 | $19.95 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $21.88 / $37.15
| Professional | | $18.62 | $21.88 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $23.99 / $35.48
| Professional | | $17.38 | $23.99 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $9.55 / $19.50
| Facility | | $8.13 | $9.55 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $20.89 / $35.48
| Professional | | $14.45 | $20.89 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $17.38 / $22.39
| Professional | | $4.37 | $17.38 | $22.39 |