- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $323.59 / $676.08
| Facility | | $43.65 | $323.59 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $4.90 / $6.31 / $11.22
| Facility | 26 | $4.90 | $6.31 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $75.86 / $457.09
| Facility | TC | $17.78 | $75.86 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $30.20 / $87.10
| Professional | | $13.49 | $30.20 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $10.00 / $35.48
| Professional | 26 | $6.03 | $10.00 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $15.49 / $79.43 / $281.84
| Professional | 50 | $15.49 | $79.43 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.79 / $20.89 / $43.65
| Professional | TC | $14.79 | $20.89 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $27.54 / $39.81
| Professional | | $19.50 | $27.54 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.89 / $8.32 / $16.98
| Professional | 26 | $5.89 | $8.32 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.80 / $17.38 / $24.55
| Professional | TC | $13.80 | $17.38 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $190.55 / $331.13
| Facility | | $72.44 | $190.55 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $21.38 / $28.84
| Professional | | $6.03 | $21.38 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $158.49 / $302.00
| Facility | | $28.18 | $158.49 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $32.36 / $51.29
| Professional | | $25.70 | $32.36 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $74.13 / $74.13
| Facility | | $26.92 | $74.13 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $21.38
| Facility | TC | $19.95 | $19.95 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $19.50 / $19.50
| Professional | 26 | $7.24 | $19.50 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $89.13 / $245.47
| Facility | | $41.69 | $89.13 | $245.47 |
- 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
- $22.39 / $30.90 / $56.23
| Professional | | $22.39 | $30.90 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $9.12 / $17.38
| Professional | 26 | $6.46 | $9.12 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.49 / $21.88 / $40.74
| Professional | TC | $15.49 | $21.88 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $186.21 / $363.08
| Facility | | $41.69 | $186.21 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | 26 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $138.04 / $138.04 / $138.04
| Facility | TC | $138.04 | $138.04 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $186.21 / $245.47
| Professional | | $35.48 | $186.21 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $67.61 / $67.61 / $67.61
| Professional | 26 | $67.61 | $67.61 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $162.18 / $186.21 / $186.21
| Professional | TC | $162.18 | $186.21 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $45.71 / $467.74
| Facility | | $25.12 | $45.71 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.01 / $6.46 / $10.23
| Facility | 26 | $5.01 | $6.46 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $52.48 / $446.68
| Facility | TC | $16.98 | $52.48 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $32.36 / $70.79
| Professional | | $19.05 | $32.36 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.89 / $9.55 / $23.99
| Professional | 26 | $5.89 | $9.55 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $15.49 / $56.23 / $281.84
| Professional | 50 | $15.49 | $56.23 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $14.79 / $23.99 / $46.77
| Professional | TC | $14.79 | $23.99 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $32.36 / $33.11
| Professional | | $6.46 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $549.54 / $549.54
| Facility | | $165.96 | $549.54 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $30.20 / $61.66
| Professional | | $8.13 | $30.20 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $37.15 / $75.86
| Facility | | $24.55 | $37.15 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $1.95 / $9.12 / $12.88
| Facility | 26 | $1.95 | $9.12 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $5.01 / $23.44 / $33.11
| Facility | TC | $5.01 | $23.44 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $30.20 / $60.26
| Professional | | $22.39 | $30.20 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $8.51 / $15.14
| Professional | 26 | $6.46 | $8.51 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.49 / $21.38 / $38.02
| Professional | TC | $15.49 | $21.38 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $81.28 / $186.21
| Facility | | $22.91 | $81.28 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $27.54 / $61.66
| Professional | | $23.44 | $27.54 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $8.32 / $24.55
| Professional | 26 | $6.92 | $8.32 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.22 / $19.95 / $42.66
| Professional | TC | $16.22 | $19.95 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $29.51 / $34.67
| Professional | | $27.54 | $29.51 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $7.76 / $9.33
| Professional | 26 | $7.59 | $7.76 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $21.38 / $25.12
| Professional | TC | $20.42 | $21.38 | $25.12 |