- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $31.62 / $51.29
| Facility | | $22.39 | $31.62 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $35.48
| Professional | | $15.14 | $15.14 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $17.78 / $36.31
| Facility | | $15.85 | $17.78 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $32.36
| Professional | | $15.14 | $15.14 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $17.78 / $22.39
| Facility | | $15.49 | $17.78 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $19.50 / $42.66
| Professional | | $15.14 | $19.50 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $25.70 / $34.67
| Facility | | $15.49 | $25.70 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $15.49
| Professional | | $15.14 | $15.14 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $16.60 / $33.88
| Professional | | $13.49 | $16.60 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $14.79 / $14.79
| Professional | | $14.79 | $14.79 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $22.91 / $38.02
| Facility | | $15.14 | $22.91 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $18.20
| Professional | | $15.14 | $15.14 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $21.38 / $21.38
| Professional | | $21.38 | $21.38 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $16.60 / $25.70
| Professional | | $12.02 | $16.60 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $39.81 / $39.81
| Facility | | $15.14 | $39.81 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $37.15
| Professional | | $15.14 | $15.14 | $37.15 |