- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.85 / $24.55
| Facility | | $10.00 | $15.85 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $14.13 / $19.05
| Professional | | $10.00 | $14.13 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $39.81
| Facility | | $19.95 | $19.95 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $40.74
| Professional | | $15.49 | $15.49 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $20.42
| Facility | | $19.05 | $19.05 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $19.05
| Professional | | $19.05 | $19.05 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $50,118.72 / $53,703.18
| Facility | | $30.90 | $50,118.72 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $93.33
| Professional | | $16.98 | $16.98 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $33.88 / $77.62
| Facility | | $20.42 | $33.88 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $36.31 / $56.23
| Professional | | $20.42 | $36.31 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $18.62
| Facility | | $16.22 | $16.22 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $19.95
| Professional | | $18.62 | $18.62 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $50,118.72 / $75,857.76
| Facility | | $35.48 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $20.42 / $93.33
| Facility | | $19.50 | $20.42 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $22.39 / $44.67
| Professional | | $10.72 | $22.39 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $18.62 / $19.50
| Facility | | $16.22 | $18.62 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $20.42
| Professional | | $18.62 | $18.62 | $20.42 |