- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $26.30 / $42.66
| Facility | | $21.38 | $26.30 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $21.88 / $30.20
| Professional | | $20.89 | $21.88 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $23.99 / $30.20
| Professional | | $22.39 | $23.99 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $52.48 / $89.13
| Professional | | $48.98 | $52.48 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $23.99 / $36.31
| Facility | | $21.38 | $23.99 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $24.55 / $100.00
| Professional | | $21.88 | $24.55 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $31.62 / $33.11
| Professional | | $28.18 | $31.62 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $33.11 / $58.88
| Professional | | $31.62 | $33.11 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $52.48
| Professional | | $30.20 | $30.20 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $23.44 / $26.30
| Facility | | $23.44 | $23.44 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $22.39 / $26.30
| Professional | | $21.88 | $22.39 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $25.70
| Facility | | $25.70 | $25.70 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $25.70 / $25.70
| Professional | | $20.42 | $25.70 | $25.70 |