- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $144.54 / $436.52
| Facility | | $51.29 | $144.54 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.22 / $17.38 / $22.39
| Facility | 26 | $11.22 | $17.38 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $32.36 / $58.88 / $295.12
| Facility | TC | $32.36 | $58.88 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $37.15 / $141.25
| Professional | | $11.48 | $37.15 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.08 / $16.98 / $39.81
| Professional | 26 | $7.08 | $16.98 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $47.86 / $56.23 / $158.49
| Professional | 50 | $47.86 | $56.23 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $10.72 / $11.75 / $169.82
| Professional | 52 | $10.72 | $11.75 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.20 / $32.36 / $81.28
| Professional | TC | $18.20 | $32.36 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $302.00 / $371.54
| Facility | | $25.70 | $302.00 | $371.54 |
- 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
- $28.18 / $57.54 / $89.13
| Professional | | $28.18 | $57.54 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.51 / $14.79 / $22.91
| Professional | 26 | $8.51 | $14.79 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $41.69 / $66.07
| Professional | TC | $20.89 | $41.69 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $69.18 / $85.11
| Professional | | $63.10 | $69.18 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $15.49 / $17.78 / $20.89
| Professional | 26 | $15.49 | $17.78 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $46.77 / $52.48 / $64.57
| Professional | TC | $46.77 | $52.48 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $51.29 / $257.04
| Facility | | $30.20 | $51.29 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $11.22 / $16.60 / $29.51
| Facility | 26 | $11.22 | $16.60 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $32.36 / $58.88 / $295.12
| Facility | TC | $32.36 | $58.88 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $54.95 / $93.33
| Professional | | $19.95 | $54.95 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $9.33 / $16.60 / $26.30
| Professional | 26 | $9.33 | $16.60 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $47.86 / $56.23 / $56.23
| Professional | 50 | $47.86 | $56.23 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $10.72 / $11.75 / $23.99
| Professional | 52 | $10.72 | $11.75 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $23.99 / $45.71 / $69.18
| Professional | TC | $23.99 | $45.71 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $38.90 / $61.66
| Facility | | $14.45 | $38.90 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $22.39 / $41.69
| Professional | | $10.96 | $22.39 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $45.71 / $79.43
| Facility | | $28.84 | $45.71 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $61.66 / $89.13
| Professional | | $46.77 | $61.66 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $10.72 / $16.22 / $23.44
| Professional | 26 | $10.72 | $16.22 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $26.30 / $42.66 / $67.61
| Professional | TC | $26.30 | $42.66 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $371.54 / $467.74
| Facility | | $295.12 | $371.54 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $389.05 / $389.05 / $389.05
| Facility | 26 | $389.05 | $389.05 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $389.05 / $389.05 / $389.05
| Facility | TC | $389.05 | $389.05 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $66.07 / $91.20
| Professional | | $50.12 | $66.07 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $14.45 / $16.98 / $22.91
| Professional | 26 | $14.45 | $16.98 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $35.48 / $48.98 / $67.61
| Professional | TC | $35.48 | $48.98 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $389.05 / $512.86
| Facility | | $316.23 | $389.05 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $35.48 / $85.11
| Professional | | $26.30 | $35.48 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.94 / $9.77 / $22.39
| Professional | 26 | $7.94 | $9.77 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $17.78 / $26.92 / $63.10
| Professional | TC | $17.78 | $26.92 | $63.10 |