- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $13.18 / $21.38
| Facility | 26 | $8.32 | $13.18 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $33.11 / $234.42
| Facility | TC | $17.38 | $33.11 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $25.12 / $66.07
| Professional | | $16.22 | $25.12 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $8.51 / $33.88
| Professional | 26 | $6.03 | $8.51 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $100.00 / $107.15 / $109.65
| Professional | 50 | $100.00 | $107.15 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $10.96 / $16.98 / $40.74
| Professional | TC | $10.96 | $16.98 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $33.11 / $37.15
| Professional | | $23.44 | $33.11 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.62 / $12.30 / $13.80
| Professional | 26 | $5.62 | $12.30 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $158.49 / $158.49 / $158.49
| Facility | 26 | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $158.49 / $158.49 / $158.49
| Facility | TC | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $45.71 / $64.57
| Professional | | $30.90 | $45.71 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $15.49 / $21.88
| Professional | 26 | $10.23 | $15.49 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $30.20 / $42.66
| Professional | TC | $19.95 | $30.20 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $38.02 / $66.07
| Professional | | $20.42 | $38.02 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $12.88 / $21.88
| Professional | 26 | $6.76 | $12.88 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.80 / $25.70 / $43.65
| Professional | TC | $13.80 | $25.70 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $14.45 / $165.96
| Facility | 26 | $8.51 | $14.45 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $29.51 / $165.96
| Facility | TC | $17.38 | $29.51 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $42.66 / $58.88
| Professional | | $22.39 | $42.66 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $13.49 / $19.05
| Professional | 26 | $7.59 | $13.49 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.49 / $27.54 / $40.74
| Professional | TC | $15.49 | $27.54 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $18.62 / $29.51
| Professional | | $8.91 | $18.62 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $10.00
| Facility | 26 | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $19.50
| Facility | TC | $19.05 | $19.05 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $43.65 / $63.10
| Professional | | $29.51 | $43.65 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $15.49 / $21.38
| Professional | 26 | $10.00 | $15.49 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $30.20 / $41.69
| Professional | TC | $19.50 | $30.20 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $158.49 / $158.49 / $158.49
| Facility | 26 | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $158.49 / $158.49 / $158.49
| Facility | TC | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $45.71 / $61.66
| Professional | | $29.51 | $45.71 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.23 / $15.49 / $20.89
| Professional | 26 | $10.23 | $15.49 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $29.51 / $40.74
| Professional | TC | $19.50 | $29.51 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $26.92 / $57.54
| Professional | | $21.88 | $26.92 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $9.12 / $21.38
| Professional | 26 | $7.41 | $9.12 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.80 / $17.78 / $37.15
| Professional | TC | $13.80 | $17.78 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $47.86
| Professional | | $25.70 | $25.70 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $8.51 / $15.14
| Professional | 26 | $7.94 | $8.51 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $33.11
| Professional | TC | $17.38 | $17.38 | $33.11 |