- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $181.97 / $436.52
| Facility | | $48.98 | $181.97 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $11.22 / $57.54
| Facility | 26 | $6.76 | $11.22 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $56.23 / $177.83
| Facility | TC | $20.89 | $56.23 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $36.31 / $87.10
| Professional | | $21.38 | $36.31 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $9.12 / $22.91
| Professional | 26 | $7.08 | $9.12 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.13 / $21.38 / $54.95
| Professional | TC | $14.13 | $21.38 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $25.12 / $30.20
| Professional | | $20.89 | $25.12 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $7.24 / $19.05
| Professional | 26 | $6.31 | $7.24 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $17.78
| Professional | TC | $17.78 | $17.78 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $398.11 / $741.31
| Facility | | $177.83 | $398.11 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $1,479.11 / $1,479.11 / $1,479.11
| Facility | TC | $1,479.11 | $1,479.11 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $34.67 / $66.07
| Professional | | $34.67 | $34.67 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $19.05
| Professional | 26 | $10.00 | $10.00 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $53.70 / $93.33
| Facility | | $48.98 | $53.70 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $5.75
| Facility | 26 | $5.75 | $5.75 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $13.49
| Facility | TC | $13.49 | $13.49 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $36.31 / $61.66
| Professional | | $22.91 | $36.31 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $10.72 / $18.20
| Professional | 26 | $6.46 | $10.72 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.79 / $23.99 / $41.69
| Professional | TC | $14.79 | $23.99 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $39.81 / $47.86
| Professional | | $28.84 | $39.81 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $11.48 / $13.80
| Professional | 26 | $8.32 | $11.48 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $28.84 / $33.88
| Professional | TC | $20.42 | $28.84 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $251.19 / $562.34
| Facility | | $30.20 | $251.19 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $9,332.54 / $25,118.86
| Facility | TC | $20.42 | $9,332.54 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $28.84 / $56.23
| Professional | | $24.55 | $28.84 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $8.51 / $16.98
| Professional | 26 | $7.24 | $8.51 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $20.42 / $42.66
| Professional | TC | $17.38 | $20.42 | $42.66 |
- 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
- $20.89 / $31.62 / $56.23
| Professional | | $20.89 | $31.62 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $9.77 / $17.38
| Professional | 26 | $6.31 | $9.77 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.79 / $22.91 / $40.74
| Professional | TC | $14.79 | $22.91 | $40.74 |