- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $169.82 / $363.08
| Facility | | $41.69 | $169.82 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.02 / $14.13 / $17.38
| Facility | 26 | $12.02 | $14.13 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $33.88 / $251.19
| Facility | TC | $26.92 | $33.88 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $53.70 / $117.49
| Professional | | $30.90 | $53.70 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $14.45 / $34.67
| Professional | 26 | $8.91 | $14.45 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $33.11 / $64.57
| Professional | TC | $22.39 | $33.11 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $38.90 / $61.66
| Professional | | $26.92 | $38.90 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $8.91 / $17.38
| Professional | 26 | $7.94 | $8.91 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $24.55 / $27.54
| Professional | TC | $22.91 | $24.55 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $107.15 / $147.91
| Facility | | $107.15 | $107.15 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $42.66 / $54.95
| Professional | | $37.15 | $42.66 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.30 / $14.13 / $18.20
| Professional | 26 | $12.30 | $14.13 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.12 / $28.84 / $36.31
| Professional | TC | $25.12 | $28.84 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $35.48 / $61.66
| Facility | | $13.49 | $35.48 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $33.88 / $58.88
| Professional | | $11.75 | $33.88 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $54.95 / $199.53
| Facility | | $38.02 | $54.95 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.63 / $12.30 / $17.38
| Facility | 26 | $2.63 | $12.30 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $6.76 / $31.62 / $44.67
| Facility | TC | $6.76 | $31.62 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $46.77 / $72.44
| Professional | | $32.36 | $46.77 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $14.13 / $21.88
| Professional | 26 | $9.55 | $14.13 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $31.62 / $48.98
| Professional | TC | $22.39 | $31.62 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $66.07 / $79.43
| Professional | | $41.69 | $66.07 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $19.50 / $23.44
| Professional | 26 | $9.33 | $19.50 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $38.90 / $54.95
| Professional | TC | $26.92 | $38.90 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $169.82 / $302.00
| Facility | | $107.15 | $169.82 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $40.74 / $77.62
| Professional | | $33.88 | $40.74 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $12.59 / $22.91
| Professional | 26 | $10.00 | $12.59 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $29.51 / $53.70
| Professional | TC | $23.99 | $29.51 | $53.70 |