- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $208.93 / $741.31
| Facility | | $77.62 | $208.93 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $11.48 / $54.95
| Facility | 26 | $6.76 | $11.48 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.20 / $85.11 / $257.04
| Facility | TC | $30.20 | $85.11 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $40.74 / $120.23
| Professional | | $9.12 | $40.74 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $13.18 / $34.67
| Professional | 26 | $7.08 | $13.18 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $17.78 / $79.43 / $208.93
| Professional | 50 | $17.78 | $79.43 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.38 / $38.02 / $83.18
| Professional | TC | $21.38 | $38.02 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $35.48 / $51.29
| Professional | | $28.18 | $35.48 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $7.76 / $15.49
| Professional | 26 | $6.76 | $7.76 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $48.98 / $48.98 / $54.95
| Professional | 50 | $48.98 | $48.98 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $32.36 / $43.65
| Professional | TC | $20.42 | $32.36 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $44.67 / $1,995.26
| Facility | | $40.74 | $44.67 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $40.74 / $75.86 / $2,187.76
| Facility | TC | $40.74 | $75.86 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $60.26 / $117.49
| Professional | | $51.29 | $60.26 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $19.05
| Professional | 26 | $10.00 | $10.00 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $87.10 / $154.88
| Facility | | $81.28 | $87.10 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $5.75
| Facility | 26 | $5.75 | $5.75 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $13.80
| Facility | TC | $13.80 | $13.80 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $46.77 / $85.11
| Professional | | $30.90 | $46.77 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $10.47 / $17.78
| Professional | 26 | $6.46 | $10.47 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $32.36 / $63.10
| Professional | TC | $21.88 | $32.36 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $60.26 / $67.61
| Professional | | $43.65 | $60.26 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.71 / $11.75 / $14.13
| Professional | 26 | $8.71 | $11.75 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $35.48 / $48.98 / $58.88
| Professional | TC | $35.48 | $48.98 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $275.42 / $467.74
| Facility | | $44.67 | $275.42 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $30.20 / $9,120.11 / $25,118.86
| Facility | TC | $30.20 | $9,120.11 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $39.81 / $79.43
| Professional | | $33.88 | $39.81 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.24 / $8.51 / $16.98
| Professional | 26 | $7.24 | $8.51 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.92 / $31.62 / $63.10
| Professional | TC | $26.92 | $31.62 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $131.83 / $204.17
| Facility | | $57.54 | $131.83 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $42.66 / $75.86
| Professional | | $26.92 | $42.66 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $9.77 / $17.38
| Professional | 26 | $6.46 | $9.77 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $33.11 / $60.26
| Professional | TC | $20.42 | $33.11 | $60.26 |