- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $162.18 / $489.78
| Facility | | $47.86 | $162.18 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $13.18 / $67.61
| Facility | 26 | $8.91 | $13.18 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.70 / $63.10 / $173.78
| Facility | TC | $25.70 | $63.10 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $43.65 / $107.15
| Professional | | $26.92 | $43.65 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $13.49 / $29.51
| Professional | 26 | $7.94 | $13.49 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $25.70 / $58.88
| Professional | TC | $17.38 | $25.70 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $26.30 / $39.81
| Professional | | $21.88 | $26.30 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $8.91 / $18.62
| Professional | 26 | $7.41 | $8.91 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $22.39 / $27.54
| Professional | TC | $20.42 | $22.39 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $239.88 / $4,168.69
| Facility | | $50.12 | $239.88 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,862.09 / $1,862.09 / $1,862.09
| Facility | TC | $1,862.09 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $48.98 / $95.50
| Professional | | $40.74 | $48.98 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $21.88
| Professional | 26 | $11.48 | $11.48 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $61.66 / $109.65
| Facility | | $57.54 | $61.66 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $7.24
| Facility | 26 | $7.24 | $7.24 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $17.38
| Facility | TC | $17.38 | $17.38 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $42.66 / $72.44
| Professional | | $26.30 | $42.66 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $13.18 / $21.38
| Professional | 26 | $7.59 | $13.18 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $28.18 / $48.98
| Professional | TC | $17.78 | $28.18 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $46.77 / $56.23
| Professional | | $33.88 | $46.77 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $13.18 / $15.85
| Professional | 26 | $9.55 | $13.18 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $24.55 / $33.88 / $40.74
| Professional | TC | $24.55 | $33.88 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $263.03 / $562.34
| Facility | | $38.02 | $263.03 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $9,332.54 / $25,118.86
| Facility | TC | $26.30 | $9,332.54 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $31.62 / $64.57
| Professional | | $19.05 | $31.62 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $9.77 / $19.95
| Professional | 26 | $8.32 | $9.77 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.38 / $23.44 / $51.29
| Professional | TC | $21.38 | $23.44 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $169.82 / $275.42
| Facility | | $57.54 | $169.82 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $37.15 / $64.57
| Professional | | $25.12 | $37.15 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $11.48 / $20.42
| Professional | 26 | $7.41 | $11.48 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $25.70 / $45.71
| Professional | TC | $17.38 | $25.70 | $45.71 |