- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $181.97 / $501.19
| Facility | | $37.15 | $181.97 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $28.18 / $38.90
| Facility | 26 | $9.12 | $28.18 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $37.15 / $57.54 / $169.82
| Facility | TC | $37.15 | $57.54 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $38.02 / $117.49
| Professional | | $16.98 | $38.02 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $14.79 / $40.74
| Professional | 26 | $7.08 | $14.79 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $33.11 / $87.10 / $190.55
| Professional | 50 | $33.11 | $87.10 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $15.85 / $27.54 / $131.83
| Professional | 52 | $15.85 | $27.54 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.05 / $28.84 / $75.86
| Professional | TC | $19.05 | $28.84 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $26.30 / $33.11
| Professional | | $22.91 | $26.30 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.89 / $6.92 / $12.02
| Professional | 26 | $5.89 | $6.92 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $39.81 / $39.81 / $43.65
| Professional | 50 | $39.81 | $39.81 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $24.55 / $42.66
| Professional | TC | $15.85 | $24.55 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $77.62 / $138.04
| Facility | | $19.05 | $77.62 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $34.67 / $141.25
| Professional | | $29.51 | $34.67 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $7.59 / $30.90
| Professional | 26 | $6.31 | $7.59 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $27.54 / $112.20
| Professional | TC | $22.91 | $27.54 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $114.82 / $269.15
| Facility | | $63.10 | $114.82 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $1.95 / $9.12 / $13.18
| Facility | 26 | $1.95 | $9.12 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $6.03 / $28.18 / $39.81
| Facility | TC | $6.03 | $28.18 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $36.31 / $70.79
| Professional | | $26.30 | $36.31 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $9.33 / $17.78
| Professional | 26 | $6.76 | $9.33 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.05 / $25.12 / $51.29
| Professional | TC | $19.05 | $25.12 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $38.02 / $74.13
| Facility | | $28.18 | $38.02 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $18.62 / $100.00 / $100.00
| Facility | 26 | $18.62 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $54.95 / $117.49 / $117.49
| Facility | TC | $54.95 | $117.49 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $33.88 / $218.78
| Professional | | $27.54 | $33.88 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $9.12 / $58.88
| Professional | 26 | $7.59 | $9.12 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $25.12 / $165.96
| Professional | TC | $19.50 | $25.12 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $74.13 / $95.50
| Facility | | $13.18 | $74.13 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $33.11 / $81.28
| Professional | | $26.92 | $33.11 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $9.12 / $40.74
| Professional | 26 | $7.41 | $9.12 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $24.55 / $75.86
| Professional | TC | $19.50 | $24.55 | $75.86 |