- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $85.11 / $380.19
| Facility | | $33.11 | $85.11 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.00 / $11.48 / $13.18
| Facility | 26 | $10.00 | $11.48 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.39 / $23.99 / $138.04
| Facility | TC | $22.39 | $23.99 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $32.36 / $93.33
| Professional | | $14.79 | $32.36 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.46 / $12.59 / $38.02
| Professional | 26 | $6.46 | $12.59 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $14.45 / $56.23 / $128.82
| Professional | 50 | $14.45 | $56.23 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $13.49 / $52.48 / $64.57
| Professional | 52 | $13.49 | $52.48 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.60 / $23.99 / $66.07
| Professional | TC | $16.60 | $23.99 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $23.99 / $30.20
| Professional | | $20.42 | $23.99 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $8.51 / $12.59
| Professional | 26 | $8.51 | $8.51 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $107.15 / $147.91
| Facility | | $107.15 | $107.15 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $33.88 / $43.65
| Professional | | $29.51 | $33.88 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.12 / $10.47 / $13.49
| Professional | 26 | $9.12 | $10.47 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $23.44 / $30.20
| Professional | TC | $20.42 | $23.44 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $28.18 / $48.98
| Facility | | $10.00 | $28.18 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $26.92 / $46.77
| Professional | | $8.71 | $26.92 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $52.48 / $199.53
| Facility | | $30.90 | $52.48 | $199.53 |
- 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
- $5.37 / $25.12 / $36.31
| Facility | TC | $5.37 | $25.12 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $36.31 / $57.54
| Professional | | $23.44 | $36.31 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $10.47 / $16.22
| Professional | 26 | $7.08 | $10.47 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $16.98 / $23.99 / $39.81
| Professional | TC | $16.98 | $23.99 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $51.29 / $57.54
| Professional | | $38.02 | $51.29 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.92 / $15.14 / $22.39
| Professional | 26 | $6.92 | $15.14 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $38.02 / $52.48 / $72.44
| Professional | 50 | $38.02 | $52.48 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $13.80
| Professional | 52 | $13.80 | $13.80 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.12 / $39.81 / $64.57
| Professional | TC | $25.12 | $39.81 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $169.82 / $302.00
| Facility | | $107.15 | $169.82 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $31.62 / $61.66
| Professional | | $25.70 | $31.62 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $9.33 / $16.60
| Professional | 26 | $7.59 | $9.33 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $22.39 / $43.65
| Professional | TC | $17.78 | $22.39 | $43.65 |