- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $389.05 / $851.14
| Facility | | $89.13 | $389.05 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $9.12 / $87.10
| Facility | 26 | $8.91 | $9.12 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $51.29 / $186.21 / $794.33
| Facility | TC | $51.29 | $186.21 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $42.66 / $125.89
| Professional | | $17.38 | $42.66 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $12.88 / $52.48
| Professional | 26 | $7.94 | $12.88 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $19.05 / $83.18 / $151.36
| Professional | 50 | $19.05 | $83.18 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $36.31 / $104.71
| Professional | TC | $19.95 | $36.31 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $25.70 / $42.66
| Professional | | $21.88 | $25.70 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $7.24 / $13.80
| Professional | 26 | $6.92 | $7.24 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $41.69
| Professional | 50 | $32.36 | $32.36 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $28.18 / $33.88 / $61.66
| Professional | TC | $28.18 | $33.88 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $46.77 / $46.77
| Facility | | $29.51 | $46.77 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $32.36 / $53.70
| Professional | | $29.51 | $32.36 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.32 / $8.51 / $14.79
| Professional | 26 | $8.32 | $8.51 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $38.90 / $44.67 / $58.88
| Professional | 50 | $38.90 | $44.67 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $23.99 / $39.81
| Professional | TC | $19.95 | $23.99 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $169.82 / $501.19
| Facility | | $58.88 | $169.82 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $39.81 / $61.66
| Professional | | $26.92 | $39.81 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $11.22 / $15.85
| Professional | 26 | $7.94 | $11.22 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $26.92 / $45.71
| Professional | TC | $18.62 | $26.92 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.24 / $42.66 / $57.54
| Professional | | $0.24 | $42.66 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $0.10 / $10.72 / $14.79
| Professional | 26 | $0.10 | $10.72 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $0.14 / $32.36 / $42.66
| Professional | TC | $0.14 | $32.36 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.24 / $0.24 / $53.70
| Professional | | $0.24 | $0.24 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $0.10 / $0.10 / $13.49
| Professional | 26 | $0.10 | $0.10 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $0.14 / $0.14 / $39.81
| Professional | TC | $0.14 | $0.14 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $35.48 / $35.48
| Professional | | $33.88 | $35.48 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $8.91 / $9.12
| Professional | 26 | $8.71 | $8.91 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.12 / $26.92 / $26.92
| Professional | TC | $25.12 | $26.92 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $181.97
| Facility | | $36.31 | $36.31 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $35.48 / $60.26
| Professional | | $25.12 | $35.48 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $9.77 / $18.20
| Professional | 26 | $6.61 | $9.77 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.60 / $23.99 / $42.66
| Professional | TC | $16.60 | $23.99 | $42.66 |