- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $24.55 / $50.12
| Facility | | $18.62 | $24.55 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $19.05 / $23.44
| Professional | | $18.20 | $19.05 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $19.05
| Facility | | $18.20 | $18.20 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $18.20
| Professional | | $18.20 | $18.20 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $16.98
| Facility | | $16.22 | $16.22 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $16.22
| Professional | | $16.22 | $16.22 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $23.99 / $27.54
| Facility | | $16.22 | $23.99 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $77.62
| Professional | | $18.20 | $18.20 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $22.39 / $63.10
| Facility | | $17.38 | $22.39 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $25.12
| Professional | | $19.95 | $19.95 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $19.05
| Facility | | $18.20 | $18.20 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $19.05
| Professional | | $18.20 | $18.20 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $50,118.72 / $75,857.76
| Facility | | $23.44 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $18.20 / $28.84
| Facility | | $17.38 | $18.20 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $18.62 / $34.67
| Professional | | $17.38 | $18.62 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $21.38
| Facility | | $18.20 | $18.20 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $19.05 / $21.88
| Professional | | $18.20 | $19.05 | $21.88 |