- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $281.84 / $602.56
| Facility | | $47.86 | $281.84 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $12.02 / $32.36
| Facility | 26 | $6.92 | $12.02 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $64.57 / $741.31
| Facility | TC | $20.89 | $64.57 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $26.30 / $60.26
| Professional | | $10.00 | $26.30 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $12.88 / $32.36
| Professional | 26 | $6.92 | $12.88 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $33.11 / $141.25 / $199.53
| Professional | 50 | $33.11 | $141.25 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $23.44 / $42.66
| Professional | TC | $15.85 | $23.44 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $120.23 / $151.36
| Facility | | $102.33 | $120.23 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $37.15 / $57.54
| Professional | | $26.92 | $37.15 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $9.77 / $15.14
| Professional | 26 | $7.08 | $9.77 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $40.74 / $56.23 / $87.10
| Professional | 50 | $40.74 | $56.23 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $27.54 / $42.66
| Professional | TC | $19.50 | $27.54 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $33.11 / $87.10
| Professional | | $12.59 | $33.11 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $8.13 / $10.23
| Professional | 26 | $7.41 | $8.13 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $25.12 / $38.02
| Professional | TC | $20.42 | $25.12 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $87.10 / $524.81
| Facility | | $51.29 | $87.10 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $12.59
| Facility | 26 | $12.59 | $12.59 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $33.88
| Facility | TC | $33.88 | $33.88 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $33.88 / $60.26
| Professional | | $22.39 | $33.88 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.03 / $9.55 / $16.98
| Professional | 26 | $6.03 | $9.55 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.60 / $23.99 / $43.65
| Professional | TC | $16.60 | $23.99 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $33.88 / $43.65
| Professional | | $28.18 | $33.88 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $8.71 / $11.22
| Professional | 26 | $7.08 | $8.71 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $25.70 / $33.11
| Professional | TC | $20.89 | $25.70 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $44.67 / $63.10
| Professional | | $35.48 | $44.67 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.48 / $14.13 / $16.98
| Professional | 26 | $11.48 | $14.13 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $38.02 / $58.88
| Facility | | $25.12 | $38.02 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $46.77
| Professional | | $30.20 | $30.20 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $26.30 / $70.79
| Facility | | $9.12 | $26.30 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $31.62 / $128.82
| Professional | | $10.23 | $31.62 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $10.23 / $17.38
| Professional | 26 | $7.94 | $10.23 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $26.92 / $46.77
| Professional | TC | $20.42 | $26.92 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $37.15 / $186.21
| Facility | | $9.55 | $37.15 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $33.88 / $58.88
| Professional | | $21.38 | $33.88 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.17 / $9.55 / $18.20
| Professional | 26 | $6.17 | $9.55 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.14 / $23.99 / $42.66
| Professional | TC | $15.14 | $23.99 | $42.66 |