- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $134.90 / $346.74
| Facility | | $33.11 | $134.90 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $10.47 / $13.49
| Facility | 26 | $8.91 | $10.47 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $22.91 / $27.54 / $91.20
| Facility | TC | $22.91 | $27.54 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $33.11 / $83.18
| Professional | | $13.18 | $33.11 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.31 / $12.30 / $38.90
| Professional | 26 | $6.31 | $12.30 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $16.98 / $77.62 / $186.21
| Professional | 50 | $16.98 | $77.62 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $11.48 / $18.62 / $48.98
| Professional | 52 | $11.48 | $18.62 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $15.85 / $23.99 / $58.88
| Professional | TC | $15.85 | $23.99 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $22.39 / $27.54
| Professional | | $17.78 | $22.39 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $8.51 / $11.48
| Professional | 26 | $7.41 | $8.51 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $31.62 / $36.31 / $39.81
| Professional | 50 | $31.62 | $36.31 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $6.03
| Professional | 52 | $6.03 | $6.03 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $35.48
| Professional | TC | $20.42 | $20.42 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $117.49 / $269.15
| Facility | | $43.65 | $117.49 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $38.90 / $44.67
| Professional | | $33.11 | $38.90 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $13.49
| Professional | 26 | $8.91 | $10.96 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $28.18 / $31.62
| Professional | TC | $23.99 | $28.18 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $39.81 / $104.71
| Facility | | $28.84 | $39.81 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.38 / $22.39 / $39.81
| Facility | TC | $21.38 | $22.39 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.59 / $20.89 / $20.89
| Professional | 26 | $7.59 | $20.89 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $61.66 / $87.10
| Facility | | $40.74 | $61.66 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $28.84 / $54.95
| Professional | | $18.20 | $28.84 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $5.37 / $8.91 / $16.60
| Professional | 26 | $5.37 | $8.91 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.18 / $21.38 / $38.90
| Professional | TC | $13.18 | $21.38 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $162.18 / $263.03
| Facility | | $44.67 | $162.18 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $30.20 / $45.71
| Professional | | $20.89 | $30.20 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.76 / $8.71 / $12.88
| Professional | 26 | $6.76 | $8.71 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $13.80 / $20.89 / $30.90
| Professional | TC | $13.80 | $20.89 | $30.90 |