- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $323.59 / $741.31
| Facility | | $48.98 | $323.59 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $7.94 / $14.13
| Facility | 26 | $6.31 | $7.94 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $93.33 / $478.63
| Facility | TC | $19.50 | $93.33 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $36.31 / $109.65
| Professional | | $25.12 | $36.31 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $10.96 / $38.02
| Professional | 26 | $7.59 | $10.96 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $22.91 / $45.71
| Professional | TC | $16.98 | $22.91 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $29.51 / $41.69
| Professional | | $22.39 | $29.51 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $10.00 / $18.62
| Professional | 26 | $7.41 | $10.00 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.14 / $22.39 / $26.30
| Professional | TC | $15.14 | $22.39 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $275.42 / $478.63
| Facility | | $112.20 | $275.42 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $25.12 / $34.67
| Professional | | $7.59 | $25.12 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $177.83 / $489.78
| Facility | | $31.62 | $177.83 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $42.66 / $61.66
| Professional | | $30.90 | $42.66 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $107.15 / $107.15
| Facility | | $30.20 | $107.15 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.38 / $21.38 / $23.44
| Facility | TC | $21.38 | $21.38 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $19.05 / $19.05
| Professional | 26 | $9.12 | $19.05 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $102.33 / $338.84
| Facility | | $47.86 | $102.33 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.34 / $10.96 / $15.85
| Facility | 26 | $2.34 | $10.96 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.37 / $25.12 / $36.31
| Facility | TC | $5.37 | $25.12 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $37.15 / $67.61
| Professional | | $26.30 | $37.15 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $12.02 / $22.91
| Professional | 26 | $8.13 | $12.02 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $25.70 / $45.71
| Professional | TC | $17.78 | $25.70 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $208.93 / $363.08
| Facility | | $48.98 | $208.93 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | 26 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $147.91 / $147.91 / $147.91
| Facility | TC | $147.91 | $147.91 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $218.78 / $275.42
| Professional | | $39.81 | $218.78 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $91.20 / $91.20 / $91.20
| Professional | 26 | $91.20 | $91.20 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $199.53 / $199.53 / $204.17
| Professional | TC | $199.53 | $199.53 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $50.12 / $389.05
| Facility | | $28.18 | $50.12 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $7.94 / $12.88
| Facility | 26 | $6.31 | $7.94 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.20 / $56.23 / $446.68
| Facility | TC | $18.20 | $56.23 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $38.02 / $83.18
| Professional | | $23.99 | $38.02 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $12.02 / $27.54
| Professional | 26 | $7.08 | $12.02 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.60 / $26.30 / $52.48
| Professional | TC | $16.60 | $26.30 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $32.36 / $33.11
| Professional | | $8.13 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $380.19 / $398.11
| Facility | | $131.83 | $380.19 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $31.62 / $70.79
| Professional | | $10.00 | $31.62 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $44.67 / $91.20
| Facility | | $28.84 | $44.67 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.45 / $11.48 / $16.22
| Facility | 26 | $2.45 | $11.48 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.50 / $25.70 / $36.31
| Facility | TC | $5.50 | $25.70 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $36.31 / $72.44
| Professional | | $26.30 | $36.31 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $10.96 / $20.42
| Professional | 26 | $8.13 | $10.96 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $23.44 / $43.65
| Professional | TC | $17.38 | $23.44 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $109.65 / $251.19
| Facility | | $29.51 | $109.65 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $33.11 / $69.18
| Professional | | $27.54 | $33.11 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $31.62
| Professional | 26 | $8.91 | $10.96 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $22.39 / $48.98
| Professional | TC | $18.62 | $22.39 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $33.11 / $39.81
| Professional | | $31.62 | $33.11 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $9.77 / $11.75
| Professional | 26 | $9.55 | $9.77 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $23.44 / $27.54
| Professional | TC | $22.39 | $23.44 | $27.54 |