- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $89.13 / $426.58
| Facility | | $45.71 | $89.13 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.18 / $14.45 / $18.20
| Facility | 26 | $13.18 | $14.45 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $39.81 / $295.12
| Facility | TC | $26.92 | $39.81 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $37.15 / $147.91
| Professional | | $23.99 | $37.15 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $12.02 / $43.65
| Professional | 26 | $7.94 | $12.02 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $23.99 / $95.50
| Professional | TC | $15.85 | $23.99 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $22.39
| Professional | | $19.05 | $19.05 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.88 / $12.88 / $15.14
| Professional | TC | $12.88 | $12.88 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $331.13 / $537.03
| Facility | | $93.33 | $331.13 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $22.91 / $39.81
| Professional | | $7.41 | $22.91 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $21.38 / $21.38
| Facility | | $21.38 | $21.38 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $39.81 / $53.70
| Professional | | $25.12 | $39.81 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $13.80 / $19.95
| Professional | 26 | $8.71 | $13.80 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $24.55 / $36.31
| Professional | TC | $17.78 | $24.55 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $32.36 / $38.02
| Professional | | $18.62 | $32.36 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $39.81 / $70.79
| Facility | | $26.92 | $39.81 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $45.71 / $74.13
| Professional | | $28.84 | $45.71 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $13.80 / $19.95
| Professional | 26 | $8.91 | $13.80 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $24.55 / $36.31
| Professional | TC | $17.78 | $24.55 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $169.82 / $380.19
| Facility | | $13.80 | $169.82 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $33.11 / $77.62
| Professional | | $29.51 | $33.11 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.47 / $11.75 / $28.18
| Professional | 26 | $10.47 | $11.75 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $21.88 / $52.48
| Professional | TC | $18.62 | $21.88 | $52.48 |