- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $38.02 / $50.12
| Facility | | $27.54 | $38.02 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $38.90
| Professional | | $18.20 | $18.20 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $21.88 / $57.54
| Facility | | $19.50 | $21.88 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $19.05 / $39.81
| Professional | | $18.20 | $19.05 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $26.92 / $38.02
| Facility | | $24.55 | $26.92 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $23.99 / $52.48
| Professional | | $18.62 | $23.99 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $32.36 / $43.65
| Facility | | $19.50 | $32.36 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $19.50
| Professional | | $18.62 | $18.62 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $19.95 / $41.69
| Professional | | $16.60 | $19.95 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $93.33 / $100.00
| Facility | | $93.33 | $93.33 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $17.78
| Professional | | $17.78 | $17.78 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $28.84 / $46.77
| Facility | | $18.62 | $28.84 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $25.70
| Professional | | $18.62 | $18.62 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $25.70
| Professional | | $25.70 | $25.70 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $20.89 / $31.62
| Professional | | $15.14 | $20.89 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $47.86 / $47.86
| Facility | | $18.62 | $47.86 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $48.98
| Professional | | $18.20 | $18.20 | $48.98 |