- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $43.65 / $53.70
| Facility | | $30.20 | $43.65 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $28.84 / $38.90
| Professional | | $21.88 | $28.84 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $61.66 / $123.03
| Facility | | $57.54 | $61.66 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $34.67 / $75.86
| Professional | | $27.54 | $34.67 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $47.86 / $47.86
| Professional | | $47.86 | $47.86 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $48.98 / $69.18
| Facility | | $28.18 | $48.98 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $51.29 / $77.62
| Professional | | $37.15 | $51.29 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $33.11
| Facility | | $31.62 | $31.62 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $22.91 / $31.62
| Professional | | $22.91 | $22.91 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $31.62
| Facility | | $31.62 | $31.62 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $22.91 / $31.62
| Professional | | $22.91 | $22.91 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $14.79 / $20.89
| Professional | | $10.47 | $14.79 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $69.18 / $69.18
| Facility | | $69.18 | $69.18 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $63.10 / $117.49
| Professional | | $53.70 | $63.10 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $46.77 / $69.18
| Facility | | $19.50 | $46.77 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $26.92 / $38.90
| Professional | | $19.05 | $26.92 | $38.90 |