- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $117.49 / $512.86
| Facility | | $31.62 | $117.49 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $14.45 / $36.31
| Facility | 26 | $7.08 | $14.45 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $48.98 / $199.53
| Facility | TC | $21.88 | $48.98 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $37.15 / $104.71
| Professional | | $16.98 | $37.15 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $14.13 / $38.02
| Professional | 26 | $7.08 | $14.13 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $30.90 / $134.90 / $323.59
| Professional | 50 | $30.90 | $134.90 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $15.85 / $29.51 / $120.23
| Professional | 52 | $15.85 | $29.51 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.05 / $26.92 / $58.88
| Professional | TC | $19.05 | $26.92 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $38.90 / $60.26
| Professional | | $25.70 | $38.90 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $10.47 / $16.22
| Professional | 26 | $6.92 | $10.47 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $39.81 / $61.66 / $181.97
| Professional | 50 | $39.81 | $61.66 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $36.31 / $43.65
| Professional | TC | $18.62 | $36.31 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $48.98 / $89.13
| Facility | | $28.84 | $48.98 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $37.15 / $66.07
| Professional | | $27.54 | $37.15 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $18.62
| Professional | 26 | $7.94 | $10.96 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $40.74 / $57.54 / $100.00
| Professional | 50 | $40.74 | $57.54 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.05 / $26.30 / $47.86
| Professional | TC | $19.05 | $26.30 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $33.11 / $48.98
| Facility | | $10.96 | $33.11 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $27.54 / $41.69
| Professional | | $8.13 | $27.54 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $57.54 / $158.49
| Facility | | $38.90 | $57.54 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $42.66 / $79.43
| Professional | | $26.92 | $42.66 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $11.75 / $20.89
| Professional | 26 | $7.24 | $11.75 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $31.62 / $60.26
| Professional | TC | $19.50 | $31.62 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $45.71 / $104.71
| Professional | | $34.67 | $45.71 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $11.48 / $28.84
| Professional | 26 | $8.51 | $11.48 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $41.69
| Professional | 52 | $30.20 | $30.20 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $34.67 / $74.13
| Professional | TC | $26.30 | $34.67 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,288.25 / $2,137.96
| Facility | | $1,288.25 | $1,288.25 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $32.36 / $58.88
| Professional | | $8.91 | $32.36 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $186.21 / $218.78
| Facility | | $21.88 | $186.21 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $36.31 / $66.07
| Professional | | $27.54 | $36.31 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $9.55 / $17.78
| Professional | 26 | $7.24 | $9.55 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.50 / $26.30 / $48.98
| Professional | TC | $19.50 | $26.30 | $48.98 |