- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $22.39 / $51.29
| Facility | | $17.78 | $22.39 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- 25
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $32.36
| Facility | 25 | $32.36 | $32.36 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $40.74 / $91.20
| Professional | | $16.98 | $40.74 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $63.10 / $64.57 / $66.07
| Professional | 25 | $63.10 | $64.57 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $45.71 / $61.66
| Professional | | $30.90 | $45.71 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $18.62 / $52.48
| Facility | | $10.96 | $18.62 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $22.91 / $56.23
| Professional | | $19.05 | $22.91 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $22.91 / $30.90
| Facility | | $17.38 | $22.91 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $52.48 / $64.57
| Professional | | $40.74 | $52.48 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $42.66 / $58.88
| Professional | | $25.12 | $42.66 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $41.69 / $51.29
| Facility | | $19.05 | $41.69 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- 25
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $32.36
| Facility | 25 | $32.36 | $32.36 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $40.74 / $72.44
| Professional | | $16.98 | $40.74 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $64.57 / $64.57 / $64.57
| Professional | 25 | $64.57 | $64.57 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $42.66 / $48.98
| Professional | | $42.66 | $42.66 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $33.11 / $81.28
| Facility | | $28.84 | $33.11 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $37.15 / $67.61
| Professional | | $18.20 | $37.15 | $67.61 |