- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $346.74 / $676.08
| Facility | | $52.48 | $346.74 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.13 / $9.77 / $338.84
| Facility | 26 | $8.13 | $9.77 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $25.70 / $87.10 / $512.86
| Facility | TC | $25.70 | $87.10 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $41.69 / $128.82
| Professional | | $10.96 | $41.69 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.41 / $14.13 / $42.66
| Professional | 26 | $7.41 | $14.13 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $27.54 / $104.71 / $190.55
| Professional | 50 | $27.54 | $104.71 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $21.88 / $38.02 / $89.13
| Professional | TC | $21.88 | $38.02 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $31.62 / $46.77
| Professional | | $23.99 | $31.62 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $6.61 / $9.77 / $15.14
| Professional | 26 | $6.61 | $9.77 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $41.69 / $52.48 / $77.62
| Professional | 50 | $41.69 | $52.48 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.42 / $28.84 / $37.15
| Professional | TC | $20.42 | $28.84 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $30.20 / $51.29
| Professional | | $27.54 | $30.20 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $8.91 / $9.77 / $16.60
| Professional | 26 | $8.91 | $9.77 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $40.74 / $45.71 / $77.62
| Professional | 50 | $40.74 | $45.71 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.20 / $19.05 / $38.02
| Professional | TC | $18.20 | $19.05 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $32.36 / $47.86
| Facility | | $8.51 | $32.36 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $27.54 / $43.65
| Professional | | $8.51 | $27.54 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $57.54 / $102.33
| Facility | | $57.54 | $57.54 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- 26
- Typical Low / Median / Typical High
- $2.04 / $9.55 / $13.49
| Facility | 26 | $2.04 | $9.55 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- TC
- Typical Low / Median / Typical High
- $6.76 / $31.62 / $44.67
| Facility | TC | $6.76 | $31.62 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $47.86 / $173.78
| Professional | | $28.84 | $47.86 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $13.18 / $41.69
| Professional | 26 | $7.76 | $13.18 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $20.89 / $37.15 / $134.90
| Professional | TC | $20.89 | $37.15 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $32.36 / $33.11
| Professional | | $7.59 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $25.12 / $66.07
| Facility | | $7.59 | $25.12 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $33.11 / $60.26
| Professional | | $26.92 | $33.11 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Typical Low / Median / Typical High
- $7.76 / $9.33 / $17.38
| Professional | 26 | $7.76 | $9.33 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Typical Low / Median / Typical High
- $18.62 / $23.44 / $41.69
| Professional | TC | $18.62 | $23.44 | $41.69 |