- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $22.91 / $30.20
| Facility | | $16.60 | $22.91 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $25.70
| Professional | | $10.96 | $10.96 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $13.49 / $35.48
| Facility | | $11.75 | $13.49 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.48 / $28.18
| Professional | | $11.22 | $11.48 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $12.88 / $20.42
| Facility | | $11.48 | $12.88 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $14.45 / $32.36
| Professional | | $11.22 | $14.45 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $19.95 / $26.92
| Facility | | $12.02 | $19.95 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $11.48
| Professional | | $11.48 | $11.48 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.30 / $25.12
| Professional | | $10.00 | $12.30 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $85.11
| Facility | | $85.11 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $10.23
| Professional | | $10.23 | $10.23 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $17.38 / $28.84
| Facility | | $11.48 | $17.38 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $13.80
| Professional | | $11.48 | $11.48 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $17.38
| Professional | | $17.38 | $17.38 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $12.59 / $19.50
| Professional | | $9.33 | $12.59 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $33.11 / $33.11
| Facility | | $11.48 | $33.11 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $27.54
| Professional | | $11.22 | $11.22 | $27.54 |