- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $30.90 / $43.65
| Facility | | $15.14 | $30.90 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $19.05
| Professional | | $14.13 | $14.13 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $15.49 / $5,011.87
| Facility | | $13.18 | $15.49 | $5,011.87 |
- 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
- $14.13 / $23.44 / $53.70
| Facility | | $14.13 | $23.44 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $14.79
| Professional | | $14.13 | $14.13 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $17.38
| Professional | | $14.13 | $14.13 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $14.13 / $14.13
| Facility | | $13.49 | $14.13 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $18.62 / $28.18
| Professional | | $14.13 | $18.62 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $29.51 / $38.02
| Facility | | $15.14 | $29.51 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $15.85
| Professional | | $14.13 | $14.13 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $28.84 / $30.20
| Professional | | $0.60 | $28.84 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $13.18 / $16.60
| Facility | | $12.02 | $13.18 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $13.49 / $22.39
| Professional | | $12.02 | $13.49 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $14.13
| Facility | | $14.13 | $14.13 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $14.13 / $16.98
| Professional | | $13.49 | $14.13 | $16.98 |