- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $16.98 / $16.98
| Facility | | $14.13 | $16.98 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $14.13 / $19.95
| Professional | | $7.94 | $14.13 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $22.91
| Professional | | $10.96 | $10.96 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $17.78
| Professional | | $17.38 | $17.38 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $15.49
| Facility | | $15.49 | $15.49 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $15.49
| Professional | | $13.18 | $13.18 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $26.30 / $33.88
| Professional | | $19.50 | $26.30 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $18.20 / $27.54
| Professional | | $10.96 | $18.20 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $17.78 / $30.90
| Facility | | $9.55 | $17.78 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $12.88 / $15.49
| Professional | | $10.47 | $12.88 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $21.38 / $69.18
| Facility | | $15.85 | $21.38 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $20.42 / $64.57
| Professional | | $13.49 | $20.42 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.00 / $13.18
| Facility | | $7.41 | $10.00 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $12.59 / $19.95
| Professional | | $10.47 | $12.59 | $19.95 |