- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $48.98 / $95.50
| Facility | | $42.66 | $48.98 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $20.89 / $30.90
| Professional | | $16.98 | $20.89 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $26.92 / $26.92
| Professional | | $26.92 | $26.92 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $69.18
| Professional | | $13.18 | $13.18 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $26.30 / $26.30
| Facility | | $26.30 | $26.30 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $26.30 / $26.30
| Professional | | $19.50 | $26.30 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $61.66 / $67.61
| Facility | | $56.23 | $61.66 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $29.51
| Professional | | $14.13 | $14.13 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $38.02 / $38.02
| Facility | | $38.02 | $38.02 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $34.67 / $45.71
| Professional | | $26.30 | $34.67 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $33.88 / $53.70
| Professional | | $24.55 | $33.88 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $26.30 / $33.88
| Professional | | $26.30 | $26.30 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $15.85 / $15.85
| Facility | | $15.85 | $15.85 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $24.55 / $61.66
| Professional | | $11.22 | $24.55 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $29.51 / $58.88
| Professional | | $22.39 | $29.51 | $58.88 |