- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $338.84 / $660.69
| Facility | | $50.12 | $338.84 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $12.30 / $512.86
| Facility | 26 | $8.71 | $12.30 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $27.54 / $77.62 / $524.81
| Facility | TC | $27.54 | $77.62 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $36.31 / $102.33
| Professional | | $9.12 | $36.31 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $10.96 / $33.11
| Professional | 26 | $7.08 | $10.96 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $17.78 / $58.88 / $229.09
| Professional | 50 | $17.78 | $58.88 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.38 / $33.88 / $85.11
| Professional | TC | $21.38 | $33.88 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $40.74 / $104.71
| Professional | | $33.11 | $40.74 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.37 / $11.22 / $28.84
| Professional | 26 | $5.37 | $11.22 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $239.88 / $269.15
| Facility | | $194.98 | $239.88 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $64.57 / $85.11
| Professional | | $42.66 | $64.57 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $12.88 / $18.62
| Professional | 26 | $8.71 | $12.88 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $64.57 / $97.72 / $128.82
| Professional | 50 | $64.57 | $97.72 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $33.88 / $51.29 / $67.61
| Professional | TC | $33.88 | $51.29 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $257.04 / $524.81
| Facility | | $151.36 | $257.04 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $151.36 / $151.36 / $151.36
| Facility | TC | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $61.66 / $112.20
| Professional | | $39.81 | $61.66 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $13.80 / $23.44
| Professional | 26 | $9.12 | $13.80 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $47.86 / $97.72
| Professional | TC | $26.30 | $47.86 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $77.62 / $117.49
| Professional | | $48.98 | $77.62 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $15.49 / $22.91
| Professional | 26 | $10.00 | $15.49 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $38.90 / $60.26 / $93.33
| Professional | TC | $38.90 | $60.26 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $58.88 / $147.91
| Professional | | $37.15 | $58.88 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.55 / $13.18 / $26.30
| Professional | 26 | $9.55 | $13.18 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.90 / $46.77 / $104.71
| Professional | TC | $30.90 | $46.77 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $38.02 / $41.69
| Facility | | $38.02 | $38.02 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $6.92 / $8.32
| Facility | 26 | $6.31 | $6.92 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $28.84 / $33.11
| Facility | TC | $26.30 | $28.84 | $33.11 |