- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $21.88 / $43.65
| Facility | | $15.14 | $21.88 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $24.55
| Professional | | $14.13 | $14.13 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $32.36
| Facility | | $18.20 | $18.20 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $18.62
| Professional | | $14.45 | $14.45 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $18.20 / $37.15
| Facility | | $14.79 | $18.20 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $18.62 / $26.92
| Professional | | $14.45 | $18.62 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $14.45 / $31.62
| Facility | | $9.33 | $14.45 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $28.84 / $28.84
| Professional | | $21.38 | $28.84 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $14.13 / $31.62
| Facility | | $9.33 | $14.13 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $15.85 / $28.84
| Professional | | $14.13 | $15.85 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $64.57 / $85.11
| Professional | | $64.57 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $13.80 / $13.80
| Facility | | $13.49 | $13.80 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $15.14 / $46.77
| Professional | | $14.45 | $15.14 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $100.00
| Facility | | $14.45 | $14.45 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $14.45
| Professional | | $14.45 | $14.45 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $19.50 / $23.99
| Professional | | $19.50 | $19.50 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $31.62
| Facility | | $13.49 | $13.49 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $16.22 / $19.50
| Professional | | $14.45 | $16.22 | $19.50 |