- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $114.82 / $426.58
| Facility | | $29.51 | $114.82 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $9.12 / $20.89
| Facility | 26 | $6.31 | $9.12 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.38 / $67.61 / $281.84
| Facility | TC | $21.38 | $67.61 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $32.36 / $93.33
| Professional | | $10.23 | $32.36 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $13.18 / $34.67
| Professional | 26 | $7.08 | $13.18 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $16.98 / $58.88 / $190.55
| Professional | 50 | $16.98 | $58.88 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.60 / $28.84 / $54.95
| Professional | TC | $16.60 | $28.84 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $22.39 / $28.18
| Professional | | $16.22 | $22.39 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $4.27 / $4.47 / $11.75
| Professional | 26 | $4.27 | $4.47 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $17.38
| Professional | TC | $17.38 | $17.38 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $27.54 / $63.10
| Professional | | $21.88 | $27.54 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.62 / $7.08 / $15.85
| Professional | 26 | $5.62 | $7.08 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $32.36 / $40.74 / $91.20
| Professional | 50 | $32.36 | $40.74 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.22 / $20.42 / $42.66
| Professional | TC | $16.22 | $20.42 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $29.51
| Facility | | $11.22 | $11.22 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $29.51 / $40.74
| Professional | | $11.22 | $29.51 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $70.79 / $169.82
| Facility | | $52.48 | $70.79 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $1.86 / $8.71 / $12.59
| Facility | 26 | $1.86 | $8.71 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.01 / $23.44 / $33.88
| Facility | TC | $5.01 | $23.44 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $39.81 / $112.20
| Professional | | $23.44 | $39.81 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.17 / $11.48 / $28.18
| Professional | 26 | $6.17 | $11.48 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $28.84 / $102.33
| Professional | TC | $16.98 | $28.84 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $28.18 / $75.86
| Facility | | $18.20 | $28.18 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $17.38
| Facility | TC | $17.38 | $17.38 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $39.81 / $61.66
| Professional | | $30.20 | $39.81 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $11.48 / $24.55
| Professional | 26 | $7.76 | $11.48 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $30.90 / $44.67
| Professional | TC | $22.91 | $30.90 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $10.00
| Facility | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $6.03
| Facility | TC | $6.03 | $6.03 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $38.02 / $69.18
| Professional | | $19.05 | $38.02 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $10.23 / $18.20
| Professional | 26 | $6.31 | $10.23 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.45 / $27.54 / $50.12
| Professional | TC | $14.45 | $27.54 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $91.20 / $257.04
| Facility | | $21.38 | $91.20 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $93.33 / $380.19
| Facility | TC | $19.50 | $93.33 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $29.51 / $50.12
| Professional | | $28.84 | $29.51 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $9.55 / $14.13
| Professional | 26 | $9.33 | $9.55 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Professional | 50 | $75.86 | $75.86 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $43.65 / $53,703.18
| Facility | | $21.88 | $43.65 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $38.90 / $75.86
| Professional | | $32.36 | $38.90 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $11.75 / $20.42
| Professional | 26 | $9.55 | $11.75 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.44 / $27.54 / $56.23
| Professional | TC | $23.44 | $27.54 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $181.97 / $213.80
| Facility | | $67.61 | $181.97 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $38.90 / $112.20
| Professional | | $25.12 | $38.90 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $10.47 / $48.98
| Professional | 26 | $6.92 | $10.47 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $29.51 / $95.50
| Professional | TC | $18.62 | $29.51 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $20.42 / $67.61
| Facility | | $10.00 | $20.42 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $9.12 / $25.70
| Facility | 26 | $6.31 | $9.12 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $6.03 / $14.45 / $50.12
| Facility | TC | $6.03 | $14.45 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $38.02 / $74.13
| Professional | | $19.05 | $38.02 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $10.23 / $22.39
| Professional | 26 | $6.31 | $10.23 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.45 / $27.54 / $57.54
| Professional | TC | $14.45 | $27.54 | $57.54 |