- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $169.82 / $346.74
| Facility | | $60.26 | $169.82 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $8.32 / $13.80
| Facility | 26 | $6.92 | $8.32 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $46.77 / $162.18 / $489.78
| Facility | TC | $46.77 | $162.18 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $38.02 / $114.82
| Professional | | $14.13 | $38.02 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $15.85 / $38.02
| Professional | 26 | $7.08 | $15.85 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $33.11 / $97.72 / $138.04
| Professional | 50 | $33.11 | $97.72 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $12.30 / $32.36 / $181.97
| Professional | 52 | $12.30 | $32.36 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $19.95 / $33.88 / $63.10
| Professional | TC | $19.95 | $33.88 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $34.67 / $38.90
| Professional | | $26.92 | $34.67 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $8.51 / $10.23
| Professional | 26 | $7.59 | $8.51 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.12 / $26.92 / $31.62
| Professional | TC | $25.12 | $26.92 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $52.48
| Facility | | $33.88 | $33.88 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $13.18
| Facility | 26 | $13.18 | $13.18 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $39.81 / $39.81 / $39.81
| Facility | TC | $39.81 | $39.81 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $34.67 / $64.57
| Professional | | $24.55 | $34.67 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.17 / $9.33 / $17.78
| Professional | 26 | $6.17 | $9.33 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.20 / $25.70 / $50.12
| Professional | TC | $18.20 | $25.70 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $40.74 / $54.95
| Professional | | $34.67 | $40.74 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $9.55 / $13.18
| Professional | 26 | $8.51 | $9.55 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $30.90 / $41.69
| Professional | TC | $26.30 | $30.90 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $16.98 / $32.36
| Facility | | $6.31 | $16.98 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $35.48 / $72.44
| Professional | | $23.44 | $35.48 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $9.33 / $17.78
| Professional | 26 | $6.46 | $9.33 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.38 / $25.70 / $53.70
| Professional | TC | $17.38 | $25.70 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $39.81 / $56.23
| Professional | | $22.91 | $39.81 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.37 / $9.12 / $12.59
| Professional | 26 | $5.37 | $9.12 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $30.90 / $43.65
| Professional | TC | $17.78 | $30.90 | $43.65 |