- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $31.62 / $58.88
| Facility | 26 | $9.12 | $31.62 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.11 / $41.69 / $114.82
| Facility | TC | $33.11 | $41.69 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $22.91 / $57.54
| Professional | | $12.88 | $22.91 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $8.91 / $20.42
| Professional | 26 | $6.03 | $8.91 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $38.90 / $45.71 / $45.71
| Professional | 50 | $38.90 | $45.71 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $10.96 / $15.49 / $33.11
| Professional | TC | $10.96 | $15.49 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $16.98 / $23.44
| Professional | | $13.49 | $16.98 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.50 / $6.31 / $10.72
| Professional | 26 | $5.50 | $6.31 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $16.98
| Professional | TC | $16.98 | $16.98 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $31.62 / $109.65
| Professional | | $26.92 | $31.62 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $16.60
| Professional | 26 | $8.71 | $8.71 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $5.01
| Facility | 26 | $5.01 | $5.01 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $12.30
| Facility | TC | $12.30 | $12.30 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $29.51 / $48.98
| Professional | | $17.78 | $29.51 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.75 / $9.55 / $15.85
| Professional | 26 | $5.75 | $9.55 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $11.48 / $19.50 / $33.88
| Professional | TC | $11.48 | $19.50 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $30.90 / $37.15
| Professional | | $22.39 | $30.90 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $10.00 / $12.02
| Professional | 26 | $7.24 | $10.00 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.14 / $20.89 / $25.12
| Professional | TC | $15.14 | $20.89 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $9,332.54 / $25,118.86
| Facility | TC | $18.62 | $9,332.54 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $21.38 / $51.29
| Professional | | $19.05 | $21.38 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $7.41 / $13.80
| Professional | 26 | $6.31 | $7.41 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $12.02 / $14.79 / $31.62
| Professional | TC | $12.02 | $14.79 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $25.70 / $43.65
| Professional | | $16.60 | $25.70 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.50 / $8.71 / $15.14
| Professional | 26 | $5.50 | $8.71 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $10.96 / $16.98 / $29.51
| Professional | TC | $10.96 | $16.98 | $29.51 |