- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $41.69 / $83.18
| Facility | | $13.80 | $41.69 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $19.95 / $25.12
| Professional | | $8.91 | $19.95 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $67.61 / $79.43
| Facility | | $56.23 | $67.61 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $18.62 / $25.12
| Professional | | $13.49 | $18.62 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $52.48 / $114.82
| Facility | | $10.47 | $52.48 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $14.79 / $32.36
| Professional | | $6.46 | $14.79 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $8.13
| Professional | | $8.13 | $8.13 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $19.95 / $26.92
| Facility | | $12.59 | $19.95 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $18.62
| Professional | | $16.22 | $16.22 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $16.60 / $29.51
| Facility | | $8.13 | $16.60 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $13.49 / $25.12
| Professional | | $9.33 | $13.49 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $117.49 / $117.49
| Facility | | $117.49 | $117.49 | $117.49 |